本文選題：病變血管 + IL-18�。� 參考：《重慶醫(yī)科大學》2005年碩士論文

【摘要】：目的:實驗擬從形態(tài)學研究動脈粥樣硬化(AS)及 AS 致動脈破裂出血血管壁纖維成分的變化以及 IL-18 在上述血管和心肌的表達,探討纖維組織和IL-18在動脈粥樣硬化和/或高血壓發(fā)病機制中的作用以及法醫(yī)學意義。 方法:1、用 Masson 三色染色法、渡邊改良法、HE 染色等實驗方法,對 A 組(AS 致動脈破裂組)10 例、B 組(AS 無破裂組)10 例、C組(正常對照組)15 例和 3 例 D 組(Ⅰ期原發(fā)性高血壓組)標本進行特殊染色,分析三種纖維的成分,探討纖維成分的變化及意義。 2、用免疫組化的方法,檢測 IL-18 在上述標本的表達;同時檢測IL-18 在 10 例心肌梗塞、11 例早期缺血和 13 例正常心肌的表達。探討IL-18在動脈粥樣硬化和/或原發(fā)性高血壓發(fā)病機制中的作用及法醫(yī)學意義。 結果:1、主動脈壁三種纖維成分的分布與含量 膠原纖維(CF)、彈力纖維(EF)、網狀纖維(RF)在 C 組動脈壁各層排列較規(guī)則,未見斷裂,其含量分別為 21.57±13.17%,32.39±4.14%,9.68±0.9%。 CF 在 A、B 組動脈壁各層明顯增多,排列不規(guī)則,含量較 C 組增多4-5 倍,CF 含量在 A、B、C 組之間兩兩比較均有顯著性差異(P0.01)。 重慶醫(yī)科大學碩士研究生學位論文 4 EF 斷裂在 A、B 組動脈壁各層明顯增多,含量較 C 組明顯減少(50% 左右), A、B 組 EF 含量與 C 組比較有顯著性差異(P0.01),A、B 組 之間沒有顯著性差異(P0.05)。 A、B 組內膜下有較多散在 RF,SMCs 層 RF 排列不規(guī)則、缺失或減 少、斷裂、塌陷成團, A、B、C 組之間 RF 含量沒有顯著性差異(P0.05) 。 在主動脈粥樣斑塊壞死區(qū)周圍,CF 增多,排列不規(guī)則,EF 明顯減 少或缺失,無 RF;A 組壞死區(qū) CF 很少甚至缺失;B 組壞死區(qū) CF 增多, 并向彈力層伸入。 D 組除內膜 CF 稍增多外,其余各層 CF、EF、RF 各層較少,排列尚 規(guī)則;EF 斷裂不明顯;RF 呈線條狀。 2、各組冠狀動脈壁 CF、EF、RF 含量及分布與主動脈類似。 3、 A、B 組脾中央動脈 CF 排列不規(guī)則,向 SMCs 浸潤生長,含量 較 C 組明顯增多, A、B 組含量與 C 組有顯著性差異(P0.01),A、B 組之間沒有顯著性差異(P0.05)。C 組 CF 分布在外膜、量少;D 組 CF 較 C 組增多;RF 分布于整個血管壁,排列較規(guī)則;含量在 A、B、C 組 沒有顯著性差異(P0.05)。(注:Masson 染色難以區(qū)分脾中央動脈管 壁 EF,故未進行統(tǒng)計分析)。 4、 IL-18 的表達 IL-18 在 A 組主動脈、冠狀動脈、脾中央動脈血管內皮細胞(ECs)、 內膜、炎性細胞(尤以巨噬細胞)及粥樣斑塊壞死區(qū)及周圍表達強陽 性; B 組呈陽性;C 組呈陰性;A、B、C 組之間兩兩比較,均有顯著性 差異(P0.05);D 組 IL-18 在主動脈、冠狀動脈呈陽性,脾中央動脈 ECs 及炎性細胞呈弱陽性。 IL-18 在正常心肌(NM)呈陰性;早期心肌缺血(EMI)呈陽性; 心肌梗塞(MI)呈強陽性,NM、EMI 與 MI 之間比較均有顯著性差異 (P0.05)。
[Abstract]:Objective : To investigate the changes of vascular wall fiber composition and the expression of IL - 18 in the vascular and myocardium of AS and AS , and to investigate the role of fibrous tissue and IL - 18 in the pathogenesis of atherosclerosis and / or hypertension , as well as the significance of forensic medicine .








Methods : The expression of IL - 18 in 10 cases , group B ( AS non - rupture group ) , group C ( normal control group ) in 10 cases , group B ( AS non - rupture group ) in 10 cases , group C ( normal control group ) in 10 cases , group B ( AS without rupture group ) , 15 cases in group C ( normal control group ) and 3 cases of D group ( stage I essential hypertension group ) were examined by immunohistochemistry .








Results : 1 . Distribution and content of three kinds of fiber components in aortic wall








Collagen fiber ( CF ) , elastic fiber ( EF ) , reticular fiber ( RF ) were regularly arranged in each layer of C - group arterial wall , and no fractures were observed . The contents were 21.57 鹵 13.17 % , 32.39 鹵 4.14 % and 9.68 鹵 0.9 % , respectively .








In group A and group B , CF increased 4 - 5 times higher in group A and group B than in group C , and CF content was significantly different between group A , B and C ( P0.01 ) .








Master ' s Degree Thesis in Chongqing Medical University








4 .








EF broke obviously in the arterial wall of group A and B , and the content of EF was significantly decreased in group C ( 50 % ) .








The EF content in group A and B was significantly different from that in group C ( P0.01 ) .








There was no significant difference between them ( P0.05 ) .








In group A and group B , there were more scattered RF , irregular , missing or reduced RF arrangements in the intima .








There was no significant difference in RF content between groups A , B and C ( P0.05 ) .








There was an increase in CF , irregular arrangement , and a significant decrease in EF around the necrotic area of the aorta








less or absent , no RF ; little or even deletion of the necrosis area CF in group A ; increased CF in group B necrosis ,








and extends into the elastic layer .








In group D , the CF , EF and RF were less and the number of CF , EF and RF was less .








Rule ; EF breaks are not obvious ; RF is linear .








2 . The levels and distribution of CF , EF , RF in each group were similar to that of the aorta .








In group A and group B , the CF of central splenic artery was irregular , infiltration and growth were observed .








There was significant difference in group A , group B and group C ( P0.01 ) , A , B were higher than those in group C ( P0.01 ) .








There was no significant difference between the groups ( P0.05 ) . CF in group C was distributed in the outer membrane , the quantity was small , and the CF in group D was less than that of group D .








Increased number of C ; RF distribution throughout the vessel wall , arrangement of rules ; content in Groups A , B , C








There was no significant difference ( P0.05 ) .








Wall EF , no statistical analysis was performed ) .








4 . Expression of IL - 18








IL - 18 was in the aorta , coronary artery and central splenic artery endothelial cells ( ECs ) in group A ,








Intima , inflammatory cell ( especially macrophages ) and atherosclerotic plaques necrotic area and surrounding expression of strong yang








sex ; group B was positive ; group C was negative ; there were significant differences between group A , B and C .








Difference ( P0.05 ) ; Group D IL - 18 was positive in aorta , coronary artery and central splenic artery .








ECs and inflammatory cells were weakly positive .








IL - 18 was negative in normal myocardium ( NM ) ; early myocardial ischemia ( EMI ) was positive ;








Myocardial infarction ( MI ) was strongly positive , and there was a significant difference between NM , EMI and MI .








(P0.05).
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2005
【分類號】：D919

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