脑动静脉畸形血管壁病理特点及血管内皮素-1在其中的表达  

Pathological Changes and Expression of Endothelin-1 in Vascular Wall of Cerebral Arteriovenous Malformations

作　　者：牛弘川[1] 王嵘[1] 王学江[2] 薛晓伟[2] 杨明[1] 段然[1] 

机构地区：[1]北京首都医科大学附属北京天坛医院神经外科,100050 [2]首都医科大学基础医学院病理生理教研室

出　　处：《中国卒中杂志》2013年第2期100-105,共6页Chinese Journal of Stroke

摘　　要：目的观察脑动静脉畸形(arteriovenous malformations,AVMs)血管壁病理结构特点,半定量检测AVMs血管壁中内皮素-1(endothelin-1,ET-1)以探讨其与AVMs破裂的关系。方法对31例AVMs患者(未破裂型15例,破裂型16例)手术切除的畸形血管内壁进行Masson常规病理染色,观察对照组(其他颅脑手术中切除的正常血管组织)、未破裂型和破裂型AVMs血管壁结构及内皮完整度情况。应用免疫组织化学染色方法半定量分析血管壁内ET-1分布.比较三组之间的差异。结果 AVMs未破裂组血管壁内皮细胞受损,中膜层平滑肌细胞减少,胶原纤维增生;AVMs破裂组血管壁内皮受损严重,平滑肌明显减少,几乎均为胶原纤维所替代。对照组、未破裂组和破裂组的ET-1平均灰度值依次为0.167±0.004、0.196±0.007和0.231±0.012,破裂组ET-1含量高于未破裂组(P=0.019)和对照组(P<0.001).未破裂组ET-1含量高于对照组(P=0.001)。结论 AVMs血管壁存在损伤,破裂型AVMs血管壁损伤更为严重。ET-1在破裂型AVMs血管壁中高表达。Objective To observe the pathological features of brain arteriovenous malformations（AVMs） and semiquantitatively measure the levels of endothelin-1 （ET-1） in the blood vessels of AVMs in order to investigate the relationship between ET-1 and the rupture of AVMs. Methods Thirty-one patients diagnosed as AVMs were divided into ruptured group（n=15） and unruptured group（a=1 6）. Our study had included the control group（the normal blood vessel excised from the other craniocerebral operation）, The tissues of the blood vessel cut from the AVMs and the normal blood vessel were stained with Masson trichrome（collagen fibers） to evaluate the vessel- wall structure and endothelial integrity, lmmunohistochemical staining was semiquantitatively performed to detect the content and distribution of ET-1 in the vessel wall and the differences among those three groups had been compared. Results The Masson trichrome staining demonstrated that the endothelial cells were damaged, smooth muscle cells were degenerated, and collagen fibers were proliferated in the media in the unruptured group. While in the ruptured group, the endothelium of blood vessel was severely damaged, the smooth muscle was obviously reduced, and almost was replaced by the collagen fibers. Mean grayscale intensity of ET-1 in the control group, non-ruptured group and ruptured group was 0.167±0.004, 0.196±0.007 and 0.231±0.012, respectively. The semi-quantitative study on vascular endothelial related factors found that ET-1 in ruptured group was significantly higher than that in unruptured group（P=0.019） and control group（P〈0.001 ）, and ET-1 in unruptured group was higher than that in control group（P=0.001 ）. Conclusion The vessel walls of AVMs are damaged. The ruptured AVMs are severely damaged. ET-1 is highly expressed in the damaged wall of the AVM.

关 键 词：动静脉畸形 病理结构 内皮素-1 

分 类 号：R743.3[医药卫生—神经病学与精神病学]