人冠狀動(dòng)脈粥樣病灶內(nèi)CD40L水平與病灶結(jié)構(gòu)變化的關(guān)系
發(fā)布時(shí)間：2018-08-17 10:14
【摘要】：目的:為了探討CD40-CD40L信號(hào)在人冠狀動(dòng)脈粥樣硬化(atherosclerosis,AS)病灶發(fā)生發(fā)展的作用,本課題進(jìn)行了人冠狀動(dòng)脈AS病灶結(jié)構(gòu)變化的觀察和病灶內(nèi)CD40L、MMP-9表達(dá)水平的檢測(cè)。方法:收集人冠狀動(dòng)脈AS血管60例作為實(shí)驗(yàn)組,按照病理分期分為四組:脂紋期5例,纖維斑塊期19例,粥樣斑塊期18例,繼發(fā)改變期18例;以無(wú)病變冠狀動(dòng)脈12例為對(duì)照組。常規(guī)HE染色觀察兩組人群冠狀動(dòng)脈的組織結(jié)構(gòu)并用圖像分析軟件測(cè)量病灶結(jié)構(gòu)的相關(guān)指標(biāo),免疫組化(Immunohistochemistry,IHC)SP兩步法檢測(cè)CD40L、MMP-9蛋白表達(dá)水平,逆轉(zhuǎn)錄-實(shí)時(shí)熒光定量PCR(Reverse transcription-quantitative real time PCR,RT-qPCR)法檢測(cè)CD40L、MMP-9 mRNA表達(dá)水平,分析CD40L、MMP-9表達(dá)水平與冠脈AS病灶結(jié)構(gòu)變化之間的關(guān)系。結(jié)果:1.對(duì)照組冠脈管壁薄,內(nèi)膜、中膜、外膜各層結(jié)構(gòu)厚度均勻一致,內(nèi)膜平滑完整。實(shí)驗(yàn)組肉眼呈從脂紋期到繼發(fā)病變期的不同變化,病變使冠脈出現(xiàn)不同程度的管壁增厚和管腔狹窄,部分病灶內(nèi)可見(jiàn)鈣化、出血、血栓形成等;光鏡下輕者僅見(jiàn)泡沫細(xì)胞增生,血管壁厚度及管腔無(wú)明顯改變;重者出現(xiàn)明顯粥樣壞死灶,甚至斑塊內(nèi)出血或血栓形成,血管壁顯著增厚,管腔明顯狹窄。2.對(duì)照組血管壁內(nèi)未見(jiàn)CD40L表達(dá),實(shí)驗(yàn)組CD40L表達(dá)水平明顯增高,陽(yáng)性表達(dá)主要分布于AS病灶肩區(qū)、基底部、纖維帽區(qū)域及壞死灶周?chē)呐菽?xì)胞及炎細(xì)胞胞漿,CD40L平均光密度值測(cè)定顯示實(shí)驗(yàn)組顯著高于對(duì)照組(P0.05),且實(shí)驗(yàn)組內(nèi)各期病變CD40L水平具有顯著性差異(P0.05)。3.對(duì)照組血管壁可見(jiàn)MMP-9蛋白少量表達(dá)于中膜平滑肌細(xì)胞及內(nèi)膜泡沫細(xì)胞的胞漿;實(shí)驗(yàn)組冠脈AS病灶內(nèi)可見(jiàn)MMP-9蛋白大量表達(dá)于泡沫細(xì)胞及炎細(xì)胞,以粥樣斑塊肩區(qū)、基底部、纖維帽區(qū)域及壞死灶周?chē)黠@,另可見(jiàn)少量表達(dá)于中膜平滑肌細(xì)胞。平均光密度值測(cè)定顯示,實(shí)驗(yàn)組MMP-9水平顯著高于對(duì)照組(P0.05);且不同病變階段的病灶內(nèi)MMP-9表達(dá)水平存在顯著性差異(P0.05)。4.RT-qPCR法檢測(cè)冠脈組織中CD40L、MMP-9 mRNA水平,結(jié)果顯示實(shí)驗(yàn)組CD40L水平高于對(duì)照組(P0.05),進(jìn)一步比較僅繼發(fā)病變期高于對(duì)照組(P0.05);MMP-9 mRNA實(shí)驗(yàn)組與對(duì)照組比較,無(wú)論組間或組內(nèi),差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5.蛋白CD40L與MMP-9的表達(dá)水平呈正相關(guān),且二者與內(nèi)膜最厚處厚度、壞死灶厚度、血管狹窄程度呈正相關(guān)(P0.05),與纖維帽厚度分?jǐn)?shù)有一定的負(fù)相關(guān)趨勢(shì)。結(jié)論:1.人冠脈AS病灶內(nèi)CD40L表達(dá)水平明顯增強(qiáng)。2.人冠脈AS病灶內(nèi)MMP-9高表達(dá),并與CD40L表達(dá)水平正相關(guān),與病灶結(jié)構(gòu)指標(biāo)變化有關(guān)。3.人冠脈AS病灶內(nèi)CD40L可能促進(jìn)MMP-9表達(dá),使病灶內(nèi)細(xì)胞外基質(zhì)(extracellular matrix,ECM)降解加速,最終導(dǎo)致病灶結(jié)構(gòu)發(fā)生纖維帽變薄、斑塊破裂等演變。
[Abstract]:Objective: to investigate the role of CD40-CD40L signal in the pathogenesis and development of human coronary atherosclerosis (as), the changes of lesion structure and the expression of CD40LMP-9 in human coronary atherosclerosis (as) were observed in this study. Methods: 60 cases of coronary artery as experimental group were divided into four groups according to pathological stages: lipid striated stage (n = 5), fibrous plaque (n = 19), atherosclerotic plaque (n = 18), secondary change (n = 18) and control group (n = 12). The tissue structure of coronary artery in both groups was observed by routine HE staining and the expression of CD40LmMMP-9 protein was detected by immunohistochemical SP two-step method with image analysis software. Reverse transcription-real-time fluorescence quantitative PCR (Reverse transcription-quantitative real time polymerase chain reaction (RT-PCR) was used to detect the expression of MMP-9 mRNA, and the relationship between the expression of MMP-9 and the structural changes of coronary atherosclerosis (as) was analyzed. The result is 1: 1. In the control group, the wall of coronary artery was thin, the thickness of each layer of intima, media and adventitia was uniform, and the intima was smooth and intact. The experimental group showed different changes from lipid-striated stage to secondary lesion stage. The lesion resulted in different degree of thickening of the coronary artery wall and stenosis of the lumen, calcification, hemorrhage, thrombosis and so on in some of the lesions, but only foam cell proliferation was observed in the light microscope. The thickness of vascular wall and lumen had no obvious change, and the severe cases had obvious atheronecrosis, even plaque hemorrhage or thrombosis, the wall of blood vessel was thickened significantly, and the lumen was obviously narrow. 2. The expression of CD40L was not found in the vascular wall of the control group, but the expression of CD40L was significantly increased in the experimental group, and the positive expression was mainly located in the shoulder region and the basal base of the as lesion. The mean optical density of CD40L in foam cells and inflammatory cells around the fibrous cap and necrotic foci was significantly higher in the experimental group than in the control group (P0.05), and the level of CD40L in each stage of the experimental group was significantly different (P0.05). In the control group, a small amount of MMP-9 protein was expressed in the cytoplasm of the medial smooth muscle cells and intimal foam cells, and in the coronary atherosclerotic plaques, the MMP-9 protein was expressed in the foam cells and inflammatory cells in the coronary atherosclerotic plaques. The fibrous cap area and the necrotic foci were obvious, and a few of them were expressed in the medial smooth muscle cells. The mean optical density showed that the level of MMP-9 in the experimental group was significantly higher than that in the control group (P0.05), and there was a significant difference in the expression of MMP-9 in different lesion stages (P0.05). 4. RT-qPCR method was used to detect the level of CD40LmMP-9 mRNA in coronary artery tissue. The results showed that the level of CD40L in the experimental group was higher than that in the control group (P0.05), and the level of MMP-9 mRNA in the experimental group was higher than that in the control group (P0.05). There was no significant difference between the experimental group and the control group (P0.05). The expression of protein CD40L was positively correlated with the expression of MMP-9, and they were positively correlated with the thickness of the thickest intima, the thickness of necrotic foci and the degree of vascular stenosis (P0.05), and had a negative correlation with the thickness fraction of the fibrous cap. Conclusion 1. The expression of CD40L in as lesions of human coronary artery was significantly increased. 2. 2. High expression of MMP-9 was found in as lesions of human coronary artery, and was positively correlated with CD40L expression, and was related to structural changes of lesions. 3. In human coronary atherosclerosis, CD40L may promote the expression of MMP-9, accelerate the degradation of extracellular matrix, and eventually lead to the formation of fibrous cap thinning and plaque rupture.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4
本文編號(hào)：2187290
[Abstract]:Objective: to investigate the role of CD40-CD40L signal in the pathogenesis and development of human coronary atherosclerosis (as), the changes of lesion structure and the expression of CD40LMP-9 in human coronary atherosclerosis (as) were observed in this study. Methods: 60 cases of coronary artery as experimental group were divided into four groups according to pathological stages: lipid striated stage (n = 5), fibrous plaque (n = 19), atherosclerotic plaque (n = 18), secondary change (n = 18) and control group (n = 12). The tissue structure of coronary artery in both groups was observed by routine HE staining and the expression of CD40LmMMP-9 protein was detected by immunohistochemical SP two-step method with image analysis software. Reverse transcription-real-time fluorescence quantitative PCR (Reverse transcription-quantitative real time polymerase chain reaction (RT-PCR) was used to detect the expression of MMP-9 mRNA, and the relationship between the expression of MMP-9 and the structural changes of coronary atherosclerosis (as) was analyzed. The result is 1: 1. In the control group, the wall of coronary artery was thin, the thickness of each layer of intima, media and adventitia was uniform, and the intima was smooth and intact. The experimental group showed different changes from lipid-striated stage to secondary lesion stage. The lesion resulted in different degree of thickening of the coronary artery wall and stenosis of the lumen, calcification, hemorrhage, thrombosis and so on in some of the lesions, but only foam cell proliferation was observed in the light microscope. The thickness of vascular wall and lumen had no obvious change, and the severe cases had obvious atheronecrosis, even plaque hemorrhage or thrombosis, the wall of blood vessel was thickened significantly, and the lumen was obviously narrow. 2. The expression of CD40L was not found in the vascular wall of the control group, but the expression of CD40L was significantly increased in the experimental group, and the positive expression was mainly located in the shoulder region and the basal base of the as lesion. The mean optical density of CD40L in foam cells and inflammatory cells around the fibrous cap and necrotic foci was significantly higher in the experimental group than in the control group (P0.05), and the level of CD40L in each stage of the experimental group was significantly different (P0.05). In the control group, a small amount of MMP-9 protein was expressed in the cytoplasm of the medial smooth muscle cells and intimal foam cells, and in the coronary atherosclerotic plaques, the MMP-9 protein was expressed in the foam cells and inflammatory cells in the coronary atherosclerotic plaques. The fibrous cap area and the necrotic foci were obvious, and a few of them were expressed in the medial smooth muscle cells. The mean optical density showed that the level of MMP-9 in the experimental group was significantly higher than that in the control group (P0.05), and there was a significant difference in the expression of MMP-9 in different lesion stages (P0.05). 4. RT-qPCR method was used to detect the level of CD40LmMP-9 mRNA in coronary artery tissue. The results showed that the level of CD40L in the experimental group was higher than that in the control group (P0.05), and the level of MMP-9 mRNA in the experimental group was higher than that in the control group (P0.05). There was no significant difference between the experimental group and the control group (P0.05). The expression of protein CD40L was positively correlated with the expression of MMP-9, and they were positively correlated with the thickness of the thickest intima, the thickness of necrotic foci and the degree of vascular stenosis (P0.05), and had a negative correlation with the thickness fraction of the fibrous cap. Conclusion 1. The expression of CD40L in as lesions of human coronary artery was significantly increased. 2. 2. High expression of MMP-9 was found in as lesions of human coronary artery, and was positively correlated with CD40L expression, and was related to structural changes of lesions. 3. In human coronary atherosclerosis, CD40L may promote the expression of MMP-9, accelerate the degradation of extracellular matrix, and eventually lead to the formation of fibrous cap thinning and plaque rupture.
【學(xué)位授予單位】：貴州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 任俊杰;劉立新;;MMPs/TIMPs介導(dǎo)的纖維消融平衡與肝纖維化的研究新進(jìn)展[J];中華消化病與影像雜志(電子版);2016年04期
2 馬清峰;李建軍;熊亮;張靜;;血清CD40、CD40L和基質(zhì)金屬蛋白酶-9水平與頸動(dòng)脈內(nèi)膜中層厚度的相關(guān)性[J];中國(guó)老年學(xué)雜志;2016年08期
3 陳偉偉;高潤(rùn)霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;鄭哲;蔣立新;胡盛壽;;《中國(guó)心血管病報(bào)告2014》概要[J];中國(guó)循環(huán)雜志;2015年07期
4 康彬;陳樹(shù)濤;馮津萍;;探討MMP-9、TIMP-1、MMP-9/TIMP-1及ICTP與冠心病的相關(guān)性[J];中國(guó)醫(yī)學(xué)創(chuàng)新;2015年12期
5 李建軍;馬清峰;張靜;熊亮;;高血壓患者頸動(dòng)脈粥樣硬化與其血清CD40/CD40L及MMP-9水平的關(guān)系[J];微循環(huán)學(xué)雜志;2014年01期
6 高菲;陳玲玲;嚴(yán)士榮;郭維軍;趙領(lǐng)會(huì);楊波;張春旺;嵇小兵;;血清MMP-1、MMP-9、TIMP-1、IL-6水平與冠狀動(dòng)脈粥樣硬化相關(guān)性研究[J];醫(yī)學(xué)臨床研究;2013年12期
7 黃文軍;劉俊明;高霞;謝偉;李科;王明建;趙亮;鄒琦;;血清基質(zhì)金屬蛋白酶-2(MMP-2)和MMP-9與急性冠狀動(dòng)脈綜合征的相關(guān)研究[J];中國(guó)循環(huán)雜志;2013年02期
8 王學(xué)懂;侯靜波;;炎癥反應(yīng)在斑塊穩(wěn)定性中的作用[J];心血管康復(fù)醫(yī)學(xué)雜志;2012年02期
9 李丹;李玉潔;楊慶;陳穎;翁小剛;鄒麗娟;朱曉新;;血管內(nèi)皮功能障礙與動(dòng)脈粥樣硬化研究進(jìn)展[J];中國(guó)實(shí)驗(yàn)方劑學(xué)雜志;2012年08期
10 李建軍;;心血管病進(jìn)展與2011回顧炎癥與冠狀動(dòng)脈粥樣硬化性疾病研究進(jìn)展[J];心血管病學(xué)進(jìn)展;2012年01期
相關(guān)會(huì)議論文 前1條
1 孫璐;韋立新;石懷銀;郭愛(ài)桃;;斑塊內(nèi)血管新生、炎細(xì)胞浸潤(rùn)與動(dòng)脈粥樣硬化病變穩(wěn)定性[A];中國(guó)病理生理學(xué)會(huì)動(dòng)脈粥樣硬化專業(yè)委員會(huì)五屆一次會(huì)議論文集[C];2002年
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