稳定型或不稳定型心绞痛患者再狭窄冠状动脉病变中的斑块炎症

Plaque inflammation in restenotic coronary lesions of patients with stable or unstable angina.

作者信息

Piek J J, van der Wal A C, Meuwissen M, Koch K T, Chamuleau S A, Teeling P, van der Loos C M, Becker A E

机构信息

Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands.

出版信息

J Am Coll Cardiol. 2000 Mar 15;35(4):963-7. doi: 10.1016/s0735-1097(99)00647-6.

DOI:10.1016/s0735-1097(99)00647-6

PMID:10732895

Abstract

OBJECTIVES

To evaluate immunohistochemically various parameters of inflammation in coronary atherectomy specimens obtained from restenotic culprit lesions of patients presenting with either stable or unstable angina (UA).

BACKGROUND

There is no information regarding the relationship between atherosclerotic plaque inflammation and the severity of the coronary syndromes in patients with restenotic coronary lesions.

METHODS

A total of 37 patients with either stable angina or UA underwent directional coronary atherectomy for restenotic coronary lesions. Cryostat sections of atherectomy specimen were immunohistochemically stained with monoclonal antibodies CD68 (macrophages [MACs]), CD3 (T-lymphocytes) and alpha-actin (smooth muscle cells [SMCs]). Smooth muscle cell contents and MAC contents were planimetrically quantified as the percentage immunopositive tissue area of the total tissue area. T-lymphocytes were counted at 100-X magnification throughout the entire section and expressed as number of cells per mm2.

RESULTS

Restenotic coronary lesions of patients with UA or stable angina showed no significant difference in SMC areas (31.9%+/-16.3% vs. 38.5%+/-18.8%, respectively; p = NS). However, restenotic coronary lesions of patients presenting with unstable angina contained significantly more MACs (24.4%+/-15.1% vs. 10.5%+/-5.8%, p = 0.001) and T-lymphocytes (18.8 cells/mm2+/-15.1 cells/mm2 vs. 8.6 cells/mm2+/-9.8 cells/mm2; p = 0.034) than patients with stable angina.

CONCLUSIONS

These results suggested that inflammation appears to affect plaque instability in restenotic coronary lesions resulting in unstable coronary syndromes.

摘要

目的

通过免疫组织化学方法评估从稳定型或不稳定型心绞痛（UA）患者的再狭窄罪犯病变处获取的冠状动脉旋切标本中的各种炎症参数。

背景

关于再狭窄冠状动脉病变患者的动脉粥样硬化斑块炎症与冠状动脉综合征严重程度之间的关系尚无相关信息。

方法

共有37例稳定型心绞痛或UA患者因冠状动脉再狭窄病变接受了定向冠状动脉旋切术。对旋切标本的低温切片进行免疫组织化学染色，使用单克隆抗体CD68（巨噬细胞[MACs]）、CD3（T淋巴细胞）和α-肌动蛋白（平滑肌细胞[SMCs]）。通过平面测量法将平滑肌细胞含量和MAC含量量化为免疫阳性组织面积占总组织面积的百分比。在整个切片上以100倍放大倍数计数T淋巴细胞，并表示为每平方毫米的细胞数。

结果

UA或稳定型心绞痛患者的再狭窄冠状动脉病变在SMC面积上无显著差异（分别为31.9%±16.3%和38.5%±18.8%；p =无统计学意义）。然而，与稳定型心绞痛患者相比，不稳定型心绞痛患者的再狭窄冠状动脉病变含有显著更多的MACs（24.4%±15.1%对10.5%±5.8%，p = 0.001）和T淋巴细胞（18.8个细胞/mm²±15.1个细胞/mm²对8.6个细胞/mm²±9.8个细胞/mm²；p = 0.034）。