用于冠状动脉搭桥手术的血管特征

M. Garnizone, E. Vārtiņa, M. Pilmane
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摘要

隐静脉常用于冠状动脉旁路移植术。因此,了解用于旁路移植的静脉壁形态是很重要的。方法。从P. Stradiņš临床大学医院心脏外科中心行冠状动脉搭桥手术的10例患者中获取10例隐静脉标本,并进行组织病理学研究。用内皮素(ET)、金属膜蛋白酶2 (MMP2)、金属蛋白酶2组织抑制剂(TIMP2)、转化生长因子β (TGF β)、肝细胞生长因子(HGF)、血管内皮生长因子(VEGF)、蛋白基因产物9.5 (PGP9.5)、血管细胞粘附分子(VCAM)、细胞间粘附分子(ICAM)对载玻片进行组织常规和免疫组化染色。免疫组化检测阳性结构分析采用半定量评价方法。结果。常规染色观察正常静脉壁组织结构。在小血管上发现中度阳性内皮素含内皮细胞和中度至大量阳性VEGF细胞。在静脉壁上发现中度阳性MMP2结构和可变的-主要是中度到大量的阳性TIMP结构。阳性结构与MMP2和TIMP的评价相同,只有一个例外,MMP2阳性结构被评价为中等,而TIMP阳性结构很少。所有标本均富含TGFβ、VCAM和ICAM细胞。VCAM和ICAM阳性内皮细胞也大量出现。内膜中HGF阳性结构较少,外膜中PGP9.5阳性神经纤维较少。结论。tgf - β、VCAM、ICAM的丰富表达是隐静脉的特征。在隐静脉壁中发现大量VEGF、MMP和TIMP阳性细胞表明存在组织重塑和缺血,而少量HGF阳性细胞表明其参与稳态调节的程度较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterisation of blood vessels used for coronary artery bypass surgery
Saphenous veins are commonly used as coronary artery bypass grafts. Therefore, it is important to understand the vein wall morphology used for the bypass grafts. Methods. Ten specimens of saphenous veins were obtained from 10 patients admitted to the Heart Surgery Centre of P. Stradiņš Clinical University Hospital for coronary artery bypass surgery and a histopathological study was conducted. The slides were processed for histological routine and immunohistochemical staining with following markers: endothelin (ET), metallomembranoproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 2 (TIMP2), transforming growth factor beta (TGF β), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), protein gene product 9.5 (PGP9.5), vascular cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM). For the analysis of the positive structures detected by immunohistochemistry, a semiquantitative evaluation method was used. Results. Normal histoarchitecture of the vein wall was evaluated by routine staining. Moderate positive endothelin containing endothelial cells and moderate to numerous positive VEGF cells were found on small blood vessels. Moderate positive MMP2 structures and variable – mainly moderate to numerous positive TIMP structures – were found in vein wall. Positive structures were evaluated as equal with both MMP2 and TIMP, with one exception where MMP2 positive structures were evaluated as moderate, but TIMP positive structures as few. All specimens were rich in TGFβ, VCAM and ICAM cells. Abundance of VCAM and ICAM positive endothelial cells was also found. Few HGF positive structures were found in tunica intima and few PGP9.5 positive nerve fibres in tunica adventitia. Conclusions. Rich expression of TGFβ, VCAM, ICAM is characteristic for saphenous vein. A number of VEGF, MMP and TIMP positive cells found in saphenous vein wall indicates a presence of tissue remodelling and ischemia, while low number of HGF positive cells shows its lesser involvement in homeostasis regulation.
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