人冠状动脉粥样硬化斑块内细胞成分与斑块稳定性的关系

人冠状动脉粥样硬化斑块内细胞成分与斑块稳定性的关系 作者：郭爱桃，石怀银，韦立新，孙璐 【关键词】 动脉硬化 Relationship between cell components in human coronary atherosclerosis plaque and stability of plaque 　　【Abstract】 AIM: To evaluate the relationship between the plaque stability and the cell components in human coronary atherosclerosis plaque and to investigate the interrelation of cell components. METHODS: One hundred and twentyfive cases of coronary cardiac diseases including acute myocardial infarction, unstable angina and stable angina, who died in recent 12 years and had full data, were selected. The coronary arteries of each case were transversely cut, embedded and stained with HE. After observing and analyzing the morphologic features, parts of the coronary artery segments were selected for immunohistochemical staining of 6 markers against αsmooth muscle actin (SMA), CD20, CD3, CD68, HLADR and mast cell tryptase. RESULTS: More macrophages, T lymphocytes and mast cells were observed infiltrated in unstable plaque and smooth muscle cells were more common in stable plaque. A significant negative correlation was found between the expression of SMA and CD68, CD3, tryptase. CONCLUSION: The decrease in the number of smooth muscle cells and the increase in the number of macrophages, T lymphocytes and mast cells may be the major pathologic mechanism responsible for plaque instability. The infiltration of macrophages, T lymphocytes and mast cells is closely related to the decrease of smooth muscle cells in plaque. 　　【Keywords】 arteriosclerosis; unstable plaque; T lymphocytes; macrophages; myocytes, smooth muscle; mast cells 　　【摘要】 目的： 探讨人冠状动脉粥样硬化斑块内细胞成分与斑块稳定性之间的关系，以及各种细胞成分之间有无必然的联系. 方法： 选取解放军总医院近12年间具有完整资料的急性心肌梗死、不稳定心绞痛和稳定心绞痛尸体解剖病例共125例，对每一例的全部冠状动脉进行取材制片，观察形态学指标，并从中挑选一部分蜡块切片行免疫组化染色(包括： SMA， CD3， CD68，CD20， HLADR， mast cell tryptase). 结果： 免疫组化标记不稳定斑块组SMA的达明显低于稳定斑块组，而CD68, CD3和mast cell tryptase的表达正好相反（P