Faculty of Medicine, Institute of Anatomy, University of Leipzig, Leipzig, Germany.
Cardiovasc Pathol. 2010 Nov-Dec;19(6):e195-203. doi: 10.1016/j.carpath.2009.10.001. Epub 2009 Nov 18.
In patients with acute mesenteric ischemia by occlusive thrombo-embolism, the superior mesenteric artery (SMA) is more affected than the inferior mesenteric artery (IMA).
This study investigated postmortem mesenteric arteries from aged subjects (n=21). Four atherosclerotic stages were defined by signs of degeneration and inflammation in sections stained with Elastica-van-Gieson and immunohistology, respectively.
In females and males, Stages 3 and 4 were found in 62% of the SMA and 24% of the IMA. Lumenal areas based on diameter measurements remained essentially unchanged between Stages 1 and 4. Compared to a Stage 1 reference, remodeling was associated with thinning of the media below the plaque base and with pronounced thickening below the shoulder in the IMA. In Stages 3 and 4, the adventitia of the IMA had more vasa vasorum and a higher number of CD45-positive leukocytes than the adventitia of the SMA. During atherosclerotic progression, a stable fraction of leukocytes represented mast cells (6%) and CD117-positive cells as potential progenitor cells (1%).
Outgrowth remodeling occurred in both the SMA and the IMA. Less severe atherosclerosis in the IMA than in the SMA was associated with stronger signs of inflammation.
在由闭塞性血栓栓塞引起的急性肠系膜缺血患者中，肠系膜上动脉（SMA）比肠系膜下动脉（IMA）更容易受到影响。
本研究调查了来自老年受试者的尸检肠系膜动脉（n=21）。通过弹力纤维-van-Gieson 染色和免疫组织化学分别显示退变和炎症的迹象，将四个动脉粥样硬化阶段定义。
在女性和男性中，SMA 的第 3 期和第 4 期分别为 62%，IMA 的第 2 期和第 4 期分别为 24%。基于直径测量的管腔面积在第 1 期和第 4 期之间基本保持不变。与第 1 期参考相比，重塑与斑块基底下方的中膜变薄以及肩部下方的显著增厚有关。在第 3 期和第 4 期，IMA 的外膜具有更多的血管腔（vasa vasorum）和更多的 CD45 阳性白细胞，而 SMA 的外膜则较少。在动脉粥样硬化进展过程中，白细胞的稳定部分代表肥大细胞（6%）和潜在的祖细胞（1%）CD117 阳性细胞。
SMA 和 IMA 都发生了外生重塑。IMA 比 SMA 更不严重的动脉粥样硬化与更强的炎症迹象相关。
