合并糖尿病的冠状动脉粥样硬化性心脏病患者大隐静脉内膜增生及NF-κB、VCAM-1表达的研究  

Pre-existing intimal hyperplasia and expression of NF-κB and VCAM-1 in great saphenous veins in patients with coronary artery disease and diabetes mellitus

作　　者：罗文琦[1] 甄文俊[1] 欧阳小康[1] 王怀斌[1] 谭洁[1] 马玉健[1] 

机构地区：[1]卫生部北京医院心血管外科, 100730

出　　处：《中华胸心血管外科杂志》2014年第7期408-410,414,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的 研究合并糖尿病的冠状动脉粥样硬化性心脏病（CHD）患者行冠状动脉旁路移植术（CABG）前,大隐静脉（GSV）血管自身存在的内膜增生和核转录因子-kappa B（NF-κB）、血管内皮细胞黏附分子-1（VCAM-1）在血管内膜的表达情况.方法 从42例择期行CABG的患者中获取GSV,其中糖尿病患者20例,非糖尿病患者22例,对获取的GSV进行形态学分析,同时采用免疫组化染色方法测定血管内膜NF-κB、VCAM-1的表达.结果 糖尿病患者GSV内膜增生发生率（85.45％）显著高于非糖尿病患者（45.45％）,且增生程度显著增强;糖尿病患者GSV内膜层中NF-κB、VCAM-1的表达显著高于非糖尿病患者,二者表达成正相关.结论 合并糖尿病的CHD患者行CABG前GSV存在显著内膜增生,且增生的内膜层中NF-κB、VCAM-1表达显著增高,可能与糖尿病患者CABG术后长期预后不良相关.Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB （NF-κB） and vascular cell adhesion molecule 1 （VCAM-1） in great saphenous vein（GSV） among the patients with diabetes mellitus undergoing coronary artery bypass grafting（CABG）.Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin （HE） staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.

关 键 词：冠状动脉旁路移植术 糖尿病 大隐静脉 内膜增生 

分 类 号：R654[医药卫生—外科学]