毛细血管进行性形成在慢性硬膜下血肿中的作用

The Role of Progressive Capillary Formation in Chronic Subdural Hematoma

目的探讨进行性毛细血管形成在慢性硬膜下血肿(CSDH)病理生理中的作用。方法收集CSDH患者手术中硬脑膜与血肿包膜标本,观察显微结构,采用免疫组织化学方法检测不同时期CSDH患者标本中CD34、SMA、TGF-β、Smad2/3表达水平,计算血管成熟指数(VMI)。结果 (1)CD34、SMA、TGF-β、Smad2/3在血肿包膜上表达远高于硬脑膜上;(2)VMI在血肿包膜上低于硬膜上,且随病情进展呈降低趋势。结论 (1)CSDH患者血肿包膜上存在进行性毛细血管形成;(2)进行性不成熟毛细血管形成参与CSDH进展;(3)在CSDH中不成熟毛细血管进行性纤维化。

ABSTRACT Objective To explore the role of progressive capillary formation in chronic subdural hematom （ CS- DH）. Methods The specimen of duramater and hematoma capsule were collected from the patients with CSDH in op- eration and microstructures were observed; immunohistochemical method was applied in detecting the expression levelsof CD34, SMA, TGF-a and Smad2/3 in the specimen from the patients with CSDH at different stages and VMI was calculated. Results The expression levels of CD3d, SMA, TGF-a and Smad2/3 in hematoma capsule were much higher than those in duramater; VMI in hematoma capsule was lower than that in duramater and it decreased with the progression of CSDH. Conclusions Progressive capillary formation exists in hematoma capsule of the patients with CS- DH; progressive immaturity angiogenesis involves in the development of CSDH ; progressive fibrosis of immaturity an- giogenesis occurs in CSDH.