INTIMAL NEOVASCULARIZATION IN HUMAN CORONARY ATHEROSCLEROSIS - ITS ORIGIN AND PATHOPHYSIOLOGICAL SIGNIFICANCE
INTIMAL NEOVASCULARIZATION IN HUMAN CORONARY ATHEROSCLEROSIS - ITS ORIGIN AND PATHOPHYSIOLOGICAL SIGNIFICANCE
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DOI：
10.1016/0046-8177(95)90148-5
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发表时间：
1995-04-01
期刊：
影响因子：
3.3
通讯作者：
SUEISHI, K
中科院分区：
文献类型：
--
作者：
KUMAMOTO, M;NAKASHIMA, Y;SUEISHI, K
为探讨人冠状动脉粥样硬化内膜新生血管的组织病理学特征，对31例冠状动脉粥样硬化内膜新生血管进行了死后冠状动脉造影，其中11例为心肌梗死。在立体镜下对血管进行三维检查。此外，我们评估了25个冠状动脉前降支与心肌梗死的发生无关的光学显微镜使用3毫米的阶梯切片和5微米的连续切片。组织学改变进行形态计量学分析，以确定内膜新生血管化程度与内皮细胞从外膜或管腔生长到动脉粥样硬化内膜之间的相关性。内膜新生血管密度与管腔狭窄发生率、慢性炎症浸润程度、肉芽组织形成或粥样硬化改变呈显著正相关，而广泛透明化和钙化内膜中血管密度降低。新生内膜血管主要来自外膜血管，也有部分来自冠状动脉固有腔。起源于外膜的内膜血管的发生频率约为起源于管腔侧的内膜血管的28倍。前者血管的频率随着管腔狭窄程度的加重而增加，而后者血管在40%和50%狭窄时最常见。起源于固有腔的血管更常与新鲜或陈旧性出血相关。我们的结论是，内膜新生血管主要来源于外膜，并与冠状动脉狭窄程度和组织学炎症反应密切相关。Hunt Pathol 26：450-456.版权所有（C）1995由W.B.桑德斯公司
To investigate the histopathological characteristics of the newly formed vessels in the atherosclerotic intima of human coronary arteries, we conducted postmortem angiography in 31 cases, including 11 with myocardial infarction. Vessels were examined three-dimensionally under the stereoscope. In addition, we evaluated 25 anterior descending coronary arteries unrelated to the occurrence of myocardial infarction by light microscopy using 3-mm stepwise sections and 5-mu m serial sections. Histological alterations were analyzed morphometrically to determine the correlation between the degree of intimal neovascularization and the growth of the endothelium into the atherosclerotic intima from the adventitia or lumen. There was a significant positive correlation between the density of new vessels in the intima and the incidence of luminal stenosis, the extent of chronic inflammatory infiltrate, the formation of granulation tissue, or the atheromatous changes, whereas the vascular density decreased in the extensively hyalinized and calcified intima. The newly formed intimal vessels originated mainly from the adventitial vasa vasorum and also partly from the proper coronary lumen. The intimal vessels that originated from the adventitia occurred approximately 28 times more frequently than those that originated from the luminal side. The frequency of former vessels increased as the luminal stenosis became more severe, whereas the latter vessels were found most frequently in the presence of 40% and 50% stenosis. Vessels originating from the proper lumen were more often associated with fresh or old hemorrhage. We conclude that intimal neovascularization largely originates from the adventitia and is closely associated with the extent of coronary stenosis and the histological inflammatory reaction. Hunt PATHOL 26:450-456. Copyright (C) 1995 by W.B. Saunders Company