颈部血管不稳定斑块的病理特点  

Pathological characteristics of unstable carotid plaques

作　　者：陈蓓蕾 李军[1] 李晓波 蒋记心 顾学文 

机构地区：[1]扬州大学临床医学院神经内科,江苏扬州225009 [2]扬州大学临床医学院病理科,江苏扬州225009

出　　处：《中风与神经疾病杂志》2014年第7期619-621,共3页Journal of Apoplexy and Nervous Diseases

基　　金：扬州市科技局资助项目(YZ2011102);江苏省卫生厅资助项目(YZ201021)

摘　　要：目的研究颈部血管不稳定斑块的病理特点,揭示缺血性脑卒中的发病机制。方法选取24例接受颈动脉内膜剥脱手术的患者的颈部血管斑块,进行HE染色及CD31、CD34以及FVIII抗体免疫组织化学染色,根据病理表现对斑块进行分类,观察不稳定斑块的病理特征。结果 24枚斑块中,13枚具有巨大脂质核心、较薄的纤维帽以及斑块内出血及继发血栓形成的为不稳定斑块,镜下可见不稳定斑块内大量炎症细胞、泡沫细胞、细胞外脂质和微小血管。CD31、CD34以及FVIII抗体免疫组织化学染色显示斑块内微小血管为新生血管。结论不稳定斑块内可见大量炎症细胞、泡沫细胞、细胞外脂质和新生血管,提示炎症反应、细胞凋亡和坏死、血管新生等病理过程与不稳定斑块的形成和发展密切相关。Objective To study the pathological characteristics of carotid plaques and elucidate the pathogenesis of ischemic stroke. Methods 24 carotid plaques from patients underwent carotid endarterectomy （CEA）were collected and stained with hematoxylin and eosin （HE）and immunohistochemistry before classified according to their pathological aspects. Then,their pathological characteristics were surveyed. Results 13 of the 24 plaques that were detected with large necrotic cores and thin fibrous cap accompanied by hemorrhage and thrombus were classified into unstable plaques, numerous inflam- matory cells,foam cells,extracellular lipid and microvessels were observed within unstable plaques. Immunohistochemical stain of these microvessels with anti-CD31 ,CD34 and FVIII antibody showed they were angiogenesis. Conclusion Numer- ous inflammatory cells, foam ceils, extracellular lipid and microvessels can be seen within the plaques, which indicates in- flammation, apoptosis, necrosis and angiogenesis are involved in the formation and progression of unstable plaques.

关 键 词：不稳定斑块 病理特点 炎症 细胞凋亡 血管新生 

分 类 号：R743[医药卫生—神经病学与精神病学]