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1、第44卷第4期第460頁華中科技大學學報(醫(yī)學版)VO1.44No.4P.4602015年8月ActaMadUnivSciTechnolHuazhongAug.2015巨噬細胞浸潤與鈣化性主動脈瓣狹窄關(guān)系的研究劉聰,謝霆?!魅A中科技大學同濟醫(yī)學院附屬協(xié)和醫(yī)院超聲科,武漢430022海南省人民醫(yī)院心臟外科,???71000摘要:目的探討巨噬細胞與老年鈣化性主動脈瓣狹窄(calcificaorticvalvestenosis,CAVS)程度的關(guān)系。方法收集2012年9月至2014年3月在海南省人民醫(yī)院心臟外科因CAVS行手術(shù)切除的嚴重鈣化主動脈瓣標本8O例[男4O例,女
2、4O例,年齡(58±6)歲],另外取因夾層動脈瘤行手術(shù)切除正常主動脈瓣標本7例[男4例,女3例,年齡(41±8)歲],選擇8o例健康成人作為對照組,收集患者的臨床基本資料,蘇木精一伊紅(HE)染色觀察CAVS瓣膜病理組織學改變;免疫組織化學(IHc)染色觀察巨噬細胞的表達特點IPP(Image—ProPlus)軟件測量巨噬細胞密度,Pearson相關(guān)分析探索巨噬細胞密度與瓣膜狹窄程度的相關(guān)性。結(jié)果與對照組比較,CAVS患者血清膽固醇和C反應(yīng)蛋白水平升高,差異有統(tǒng)計學意義,HE染色可見CAVS瓣膜損傷部位有炎性細胞浸潤、新生毛細血管和鈣化灶形成。IHC染色觀察,巨噬細
3、胞標志CD68在正常主動脈瓣膜無陽性表達,而在CAVS瓣膜中呈陽性表達,分布在鈣化灶以及骨樣組織周圍;相關(guān)分析表明巨噬細胞最大密度值與瓣VI壓力階差峰值(r一0.75,PG0.05)、平均壓力階差(r一0.75,PGO.05)、主動脈瓣口流速峰值(r0.72,PG0.05)呈正相關(guān),而與瓣口面積呈負相關(guān)(r一~0.71,P<0.05)。結(jié)論與對照組比較,CAVS患者血清膽固醇和C反應(yīng)蛋白濃度升高;與正常瓣膜比較,CAVS瓣膜中巨噬細胞浸潤,巨噬細胞密度與鈣化性主動脈狹窄程度呈正相關(guān)。關(guān)鍵詞:鈣化性主動脈瓣狹窄;巨噬細胞;C反應(yīng)蛋白中圖分類號:R542.5DOI:10
4、.3870/j.issn.1672—0741.2015.04.019PositiveAssociationbetweenMacrophageInfiltrationandSenileCalcificAorticStenosisLiuCong.XieTing△DepartmentofUltrasonography,UnionHospital,TongjiMedicalCollege,HuazhongUniversityofScienceandTechnology,Wuhan430030,China。DepartmentofCardiacSurgery,Ha~nanGe
5、neralHospital,Haikou571000,ChinaAbstractOeetiveToinvestigatetherelationbetweenmacrophageinfiltrationanddegreeofcalcificaorticstenosis(CAVS)inelderpatients.MethodsTheaorticvalvespecimenswerecollectedfrom2O12Septemberto2014MarchinDepart—mentofCardiacSurgeryofHa~nanGeneralHospital,foroper
6、ationremova1,from80cases[40malesand40females,age:(58±6)yearsold]:norma1aorticvalvespecimenswerecollectedfrom7patientsundergoingsurgicalremovalofthenormalaorticvalvebecauseofaneurysmf-4males,3femalepatients,aged(41±8)years],and80healthyadultsservedascontrolgroup.Theclinicaldataofpatient
7、swerecollected,andCAVSvalveandnorma1valvewereobservedbvHEstaining.Expressionfeatureofmacrophageswasstudiedbyimmunohistochemical(IHC)staining.IPP(Image—ProPlus)softwarewasusedtomeasurethedens~一tyofmacrophages,andPearsonrelationanalysiswasemployedtostudythecorrelationbetweenthedensityo