不同部位大隐静脉管壁细胞凋亡研究  

Apoptosis in the walls of different segments of great saphenous varicose veins

作　　者：张晶晶 王磊[2] 吴洪娟[3] 孙延平 徐永波 李坤 唐金元 褚海波 

机构地区：[1]解放军第八十九医院普外中心,山东省潍坊261021 [2]潍坊医学院研究生部 [3]潍坊医学院电镜室

出　　处：《中华普通外科杂志》2016年第4期289-292,共4页Chinese Journal of General Surgery

基　　金：潍坊市科技发展计划基金资助项目（2014zj1058）

摘　　要：目的检测不同部位曲张大隐静脉管壁细胞凋亡水平变化，探讨细胞凋亡与静脉管壁扩张之间的相互关系。方法收集21例曲张大隐静脉（曲张组）和12例正常大隐静脉（对照组），采用TUNEL和免疫荧光染色、Bax和Bcl-xl免疫组化、电镜扫描，观察细胞凋亡水平和超微结构改变。结果曲张组上、中、下3段管壁（内膜和中膜）凋亡细胞比率与对照组相比明显减少（均P〈0．05）；对照组下段管壁凋亡细胞比率与上段相比明显减少（P〈0．05）。曲张组3段管壁Bcl—xl凋亡蛋白呈高阳性表达；对照组Bax凋亡蛋白呈高阳性表达。曲张组上、中、下3段管壁Bcl-xl／Bax比值分别与对照组相应段相比明显增加（P〈0．05）。电镜显示，曲张和对照组凋亡细胞（内皮和平滑肌）形态学呈现线粒体嵴模糊、髓样变、核染色质边集。结论在静脉高压下，曲张静脉经线粒体通道引发细胞凋亡调节异常。导致静脉管壁增厚，管腔扩张，这可能是静脉曲张发病机制之一。Objective To investigate the relationship between apoptosis and great saphenous varicose veins. Methods 21 cases with great saphenous veins （varicose group） and 12 cases with normal great saphenous veins （control group ） were collected. Apoptosis was evaluated by the TUNEL and staining, as well as Bax and Bcl-xl proteins expression. The morphology of apoptotic cells was observed with an electron microscope. Results In the varicose group, the apoptotic rates in the venous walls （ intima and media） within the upper, middle, and lower segments were significantly lower than the corresponding regions in the control group （ all P 〈 0. 05 ）. In control group a significantly higher apoptotic rates of the venous walls was observed within the upper compared with the lower segment （P 〈 0.05）. The high positive expression of Bcl-xl proteins was detected in the varicose group, while the high positive expression of Bax proteins was observed in the control group. Significantly higher Bcl-xl/Bax was detected in the varicose group compared with control group in the upper, middle, and lower segments. Electron microscopic observations confirmed that endothelial and smooth muscle cells in two groups exhibited apoptotic morphologic features, such as fuzzy mitochondrial cristae, medullary changes, and margination of the nuclear chromatin. Conclusion Under high venous pressure, dysregulation of apoptosis via the mitochondrial pathways in varicose veins leads to down-regulation of apoptosis, which resulted in wall thickening, and venous dilatation. This may be one of the mechanism of venous diseases.

关 键 词：静脉曲张 细胞凋亡 隐静脉 

分 类 号：R692.5[医药卫生—泌尿科学]