摘要
目的探讨巨噬细胞与老年钙化性主动脉瓣狭窄(calcific aortic valve stenosis,CAVS)程度的关系。方法收集2012年9月至2014年3月在海南省人民医院心脏外科因CAVS行手术切除的严重钙化主动脉瓣标本80例[男40例,女40例,年龄(58±6)岁],另外取因夹层动脉瘤行手术切除正常主动脉瓣标本7例[男4例,女3例,年龄(41±8)岁],选择80例健康成人作为对照组,收集患者的临床基本资料,苏木精-伊红(HE)染色观察CAVS瓣膜病理组织学改变;免疫组织化学(IHC)染色观察巨噬细胞的表达特点;IPP(Image-Pro Plus)软件测量巨噬细胞密度,Pearson相关分析探索巨噬细胞密度与瓣膜狭窄程度的相关性。结果与对照组比较,CAVS患者血清胆固醇和C反应蛋白水平升高,差异有统计学意义,HE染色可见CAVS瓣膜损伤部位有炎性细胞浸润、新生毛细血管和钙化灶形成。IHC染色观察,巨噬细胞标志CD68在正常主动脉瓣膜无阳性表达,而在CAVS瓣膜中呈阳性表达,分布在钙化灶以及骨样组织周围;相关分析表明巨噬细胞最大密度值与瓣口压力阶差峰值(r=0.75,P<0.05)、平均压力阶差(r=0.75,P<0.05)、主动脉瓣口流速峰值(r=0.72,P<0.05)呈正相关,而与瓣口面积呈负相关(r=-0.71,P<0.05)。结论与对照组比较,CAVS患者血清胆固醇和C反应蛋白浓度升高;与正常瓣膜比较,CAVS瓣膜中巨噬细胞浸润,巨噬细胞密度与钙化性主动脉狭窄程度呈正相关。
Objective To investigate the relation between macrophage infiltration and degree of calcific aortic stenosis(CAVS)in elder patients.Methods The aortic valve specimens were collected from 2012 September to 2014 March in Department of Cardiac Surgery of Hainan General Hospital,for operation removal,from 80cases[40males and 40 females,age:(58±6)years old];normal aortic valve specimens were collected from 7patients undergoing surgical removal of the normal aortic valve because of aneurysm[4males,3female patients,aged(41±8)years],and 80 healthy adults served as control group.The clinical data of patients were collected,and CAVS valve and normal valve were observed by HE staining.Expression feature of macrophages was studied by immunohistochemical(IHC)staining.IPP(Image-Pro Plus)software was used to measure the density of macrophages,and Pearson relation analysis was employed to study the correlation between the density of macrophages and the degree of valve stenosis.Results As compared with healthy adults,cholesterol and C reactive protein in patients with CAVS were significantly elevated.There were infiltration of inflammatory cells,new blood capillaries and calcification in the valves of CAVS lesions observed by HE staining.No positive expression of macrophage marker CD68 was found in normal aortic valves,but CD68 positive expression was observed in the valves of CAVS by IHC staining,and mainly concentrated in the peripheral calcification and osteoid tissues.Simple linear regression analysis showed the density of macrophages was positively correlated with the large pressure gradient(r=0.75,P〈0.05),the average differential pressure(r=0.75,P〈0.05),and the maximum aortic jet velocity(r=0.72,P〈0.05),however,was negatively correlated(r=-0.71,P〈0.05)with the valve orifice area.Conclusion Compared with healthy adult volunteers,the concentration of cholesterol and C reactive protein were elevated in blood of the patients with CAVS.Compared with the normal valve,the macrophages were infiltrated in CAVS valves;the density of macrophage was positively correlated with the degree of CAVS.
出处
《华中科技大学学报(医学版)》
CAS
CSCD
北大核心
2015年第4期460-463,共4页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong