含血栓的曲张静脉管壁内皮和平滑肌细胞的电镜改变  

Under electron microscopic changes of endothelial and smooth muscle cells in the wall of varicose vein with thrombus

作　　者：刘国正[1] 菅凤国[1] 孙宏杰[1] 褚海波[2] 徐永波[2] 边小维[3] 严菲[3] 张圣明[3] 蒋吉英[3] 

机构地区：[1]昌邑市人民医院普外科,山东省261300 [2]解放军第89医院普外中心 [3]潍坊医学院电镜室

出　　处：《中华临床医师杂志（电子版）》2011年第11期3151-3154,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细胞学重塑特征。方法收集单纯曲张大隐静脉管壁标本27例,含血栓的曲张大隐静脉管壁标本23例,另设13例正常大隐静脉管壁标本作对照,制作切片在电镜下观察。结果血栓组内皮细胞内有"棒状小体"(11/23)、"圆形颗粒"(10/23);平滑肌细胞核型不规则(17/23),部分线粒体嵴模糊、空泡变、髓样变(19/23),肌丝基本消失(20/23);曲张组平滑肌细胞核型不规则(5/27),线粒体有嵴断裂、空泡变、髓样变(6/27),细胞质中肌丝少;对照组内皮细胞细胞质内见大量线粒体、粗面内质网及核糖体,平滑肌细胞呈梭形,细胞质内含有大量肌丝,细胞器很少。结论血栓组管壁内皮细胞和平滑肌细胞微观结构改变比曲张组更明显,推测可能与静脉高压和缺氧加重有关。Objective To investigate the characters of cytologic remodeling in the wall of varicose vein with thrombus.Methods Collecting 27 specimens of simple varicose veins,23 specimens of varicose veins with thrombus and 13 specimens of normal venous tissue used as comparison.The specimens were made into slices and observed by electron microscope.Results In thrombosis group,there were ‘rod-shaped bodies’ (11/23)and ‘round granules’(10/23) with heightened electron density in endothelial cells of varicose vein with thrombus;in smooth muscle cells,the shapes of karyon were irregular(17/23),some mitochondrial cristae were blurry,vacuolated change,and demyelination(19/23),myofilament disappear practically(20/23).In varicose group,the shapes of karyon were irregular(5/27),some mitochondrial cristae break,vacuolated change,and demyelination(6/27),myofilament reduced in endochylema.In control group,there were a large number of mitochondria,rough surfaced endoplasmic reticulum and ribosome in endochylema of endothelial cells.Smooth muscle cells were fusiform,there were a large amount of myofilament and very few organelles in their endochylema.Conclusions The micro-structural changes of vascular endothelial cells and smooth muscle cells in thrombosis group are more apparent than in varicose group.We speculate that maybe related to the aggravation of hypertension and hypoxia.

关 键 词：静脉曲张 血栓形成 内皮细胞 肌细胞 平滑肌 

分 类 号：R654.3[医药卫生—外科学]