含血栓的曲张静脉管壁组织形态学重塑机制的研究  

Study of the mechanism of histomorphology remodeling in the wall of varicose vein with thrombus

作　　者：菅凤国[1] 刘国正[1] 孙宏杰[1] 褚海波[2] 徐永波[2] 王涛[2] 边小维[3] 郭文君[3] 

机构地区：[1]昌邑市人民医院普外科 [2]解放军第89医院普外中心 [3]潍坊医学院病理教研室

出　　处：《中华临床医师杂志（电子版）》2011年第7期1938-1941,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨含血栓的曲张静脉管壁组织学重塑的特征。方法收集单纯曲张大隐静脉管壁标本27例(曲张组),含血栓的曲张大隐静脉管壁标本23例(血栓组),另设13例正常大隐静脉管壁标本作对照(对照组),HE和Masson染色制作切片在光镜下观察。结果血栓组内膜明显增厚,见Masson's瘤样增生,胶原纤维自破裂内膜处增生并延伸至血栓内致部分血栓机化,弹力纤维分离、断裂;中膜界限不清,增生胶原纤维呈不规则状穿插至平滑肌束间,可见玻璃样变、黏液样变;外膜见弹力纤维被增生的胶原纤维组织穿插变稀,滋养血管明显增多,且管腔增大,管壁全层及血栓内均见大量炎细胞浸润。曲张组内膜内皮细胞完整,内膜层呈不均匀增厚;中膜胶原纤维增生,平滑肌排列紊乱;外膜有中量滋养血管分布,偶见炎细胞浸润。结论静脉血栓形成有可能是加重引发静脉血管壁组织学结构重塑的重要因素之一。Objective To investigate the characteristics of histological remodeling in the wall of varicose vein with thrombus.Methods We collected 27 specimens of simple varicose veins,23 specimens of varicose veins with thrombus and 13 specimens of normal venous tissue used as control to compare.These specimens were made into slices by HE staining and Masson staining,then they were observed by light microscope.Results In thrombus group,intima was obviously thickened,Masson′s tumor-like proliferation was observed,collagen fibers extended into the thrombus from the cracked position of intima and induced it to be organizated,elastic fibers were asymphytous and cracked.In tunica media,the boundary was obscure,while hyperplastic collagen fibers irregularly interspersed into smooth muscle bundles,we could also observe hyalinization and mucoid degeneration.In adventitia,elastic fibers were thinned due to the interspersion of hyperplastic collagen fibers,the number amount of vasa vasorums significantly increased,and the lumen of them largened,the full-thickness of venous wall and thrombus were infiltrated by massive inflammatory cells.In varicose group,endothelial cells of intima were intact,and theca interna was apparently thickened;in tunica media,collagen fibers proliferated,and smooth muscle disorganized;in adventitia,the number of vasa vasorums was amount medium dose,the infiltration of inflammatory cells were occasionally observed.Conclusions Vein thrombosis may be one of the important factors which aggravate or initiate the histological structure remodeling of varicose vein wall.

关 键 词：静脉曲张 血栓形成 组织学 血管重塑 

分 类 号：R543.6[医药卫生—心血管疾病]