高血压病患者肾门小动脉外膜组织学观察

Histological observation of the small arterial adventitia in renal hilum in hypertensive patients

目的 阐明高血压病患者小动脉外膜的组织病理改变特点。方法 采用手术切除的肾脏组织 ,对 6例高血压病患者的肾门小动脉外膜进行组织学观察 ,用免疫组化法检查Ⅰ、Ⅴ型胶原在血管外膜中的分布情况 ,与 7例正常血压者血管进行比较 ,并用图像分析技术进行定量研究。结果 Ⅰ、Ⅴ型胶原蛋白大多分布于血管外膜部分 ,高血压病患者血管中膜及内膜中出现大量胶原物质。血管组织胶原总厚度 /血管壁总厚度比值、血管壁横截面的血管组织胶原总面积 /血管壁总面积比值和Ⅰ、Ⅴ型胶原总厚度 /血管壁总厚度 ,高血压组均较正常血压组显著增高。结论 高血压病患者小动脉血管外膜的胶原蛋白明显增多 ,外膜增厚 ,提示血管外膜在高血压血管重塑中的重要性。

Objective To study the pathological characteristics of adventitia of small artery in human essential hypertension. Methods The specimens of renal hilum artery were obtained from surgical operation. The morphological analysis of histological cross-sectional areas of vessels from patients with essential hypertension was compared with those from normotensive controls. The distribution of collagen typeⅠ and Ⅴ in arterial adventitia was determined by an immunohistochemical technique. An image system was used for quantitative measurement of vessel wall. Results The collagen type I and Ⅴ are mainly distributed in the adventitia in normotensive patients, while the deposition of collagen could be observed throughout vascular media and intima from hypertensive patients. Compared with normotensive group,the ratio of whole collagen thickness to wall thickness, the ratio of collagen area to arterial cross-sectional area and the ratio of collagen type I or Ⅴ thickness to wall thickness were significantly increased in the hypertension group. Conclusion The adventitia remodeling exists in essential hypertension, showing an increase in adventitial thickness and its collagen deposition. It is suggested that arterial adventitia may participate in the remodeling process of vessel wall in hypertension.