门静脉高压症患者肝外血管平增肌细胞凋亡及其相关基因表达的研究

Extrahepatic vascular smooth muscle cell apoptosis and apoptosis-related-gene expression in patients with portal hypertension

目的 观察门静脉高压症患者肝外血管平滑肌细胞凋亡及相关基因表达,探讨其对门静脉高压症时内脏高动力循环形成的作用。方法 采用原位DNA片断末端标记(TUNEL)法和免疫组织化学法,检测28例门静脉高压症患者脾静脉和12例正常血管的平滑肌细胞凋亡及其相关基因bax、bcl-2的表达。结果 门静脉高压症患者脾静脉平滑肌细胞TUNEL阳性细胞数为(24.3±2.6)％,正常对照组仅为(0.8±0.2)％,差异有非常显著性(P<0.01),bax与bcl-2阳性表达率分别为(22.06±3.20)％和(18.61±2.00)％,与对照组比较差异有非常显著性(P<0.01)。结论 门静脉高压症患者肝外血管平滑肌细胞可产生凋亡,bax和bcl-2蛋白参与血管平滑肌细胞凋亡的调节,凋亡与增殖失衡导致血管结构重塑,促进门静脉高压症时内脏高动力循环的形成和发展。

Objective To stndy the extrahepatic vascular smooth muscle cell apoptosis and its in- fluence on the formation of splanchnic high dynamic circulation in patients with portal hypertension. Methods The apoptosis of extrahepatic vascular smooth muscle cells was detected by TUNEL. The ex- pression of bax and bcl--2 protein was detected by immunohistochemical technique in 28 cases of splenic vein with portal hypertension and 12 cases of normal vasculature. Results TUNEL-positive cell was ac- counted for (24. 3±2. 6)%, significantly different that in normal vasculature [(0. 8±0. 2)%, P< 0. 01]. The bax and bcl-2 immunostaining-positive cellswere accounted for (22. 06±3. 20)% and (18. 61±2. 00)% in the patients and normal controls, respectively. bax was higher than bcl-2 (P < 0. 01). Conclusion Apoptosis of extrahepatic vascular smooth muscle cell occurs in patients with portal hypertension. bax and bcl-2 protein may be involved in the regulation of apoptosis of extrahepatic vascular smooth muscle cell. The imbalance of apoptosis and proliferation results in vascular remodeling and pro- motes the development of splanchnic high dynamic circulation.