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急性心肌梗死患者冠状动脉血栓中内皮细胞增殖的早期发生:对斑块愈合的影响。

Early onset of endothelial cell proliferation in coronary thrombi of patients with an acute myocardial infarction: implications for plaque healing.

机构信息

Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

出版信息

J Thromb Haemost. 2012 Mar;10(3):466-73. doi: 10.1111/j.1538-7836.2012.04620.x.

Abstract

AIMS

Coronary thrombotic occlusion in ST-segment elevation myocardial infarction (STEMI) patients is often preceded by episodes of progressive growth of the thrombus mass. Similar to wound healing, the organization of thrombus could depend on ingrowth of microvessels in order to stabilize its structure. We investigated the patterns of neovascularization in different stages of coronary thrombus evolution.

MATERIAL AND METHODS

Thrombectomy materials obtained from STEMI patients were histologically classified according to thrombus age in three groups: fresh (< 1 day), lytic (1-5 days) or organized (> 5 days) thrombi. Forty thrombi of each group were randomly collected. Neovascularization in the thrombi was evaluated histomorphologically and with immunodouble stains to visualize various differentiation antigens of endothelial cells (ECs) and primitive cells.

RESULTS

Morphologically, ECs in the coronary thrombi manifested as: single cells, cell clusters or microvessels. CD31+/CD34+ ECs were present in 98% of all the thrombi. In addition, endothelial clusters were found in 63% of the fresh thrombi (< 1 day). CD105+, Ki67+, or C-kit+ ECs (active, proliferating cells) were observed in all the stages, but significantly more in organized thrombi (> 5 days) compared with fresh and lytic ones (< 5 days), and mainly as cell clusters (P ≤ 0.05 for all). CD133+ primitive cells were found only sporadically in 11% of all the samples.

CONCLUSION

EC proliferation is initiated very early, and gradually progresses during the organization process of thrombus after coronary plaque disruption, with only a limited contribution of primitive cells in this process.

摘要

目的

ST 段抬高型心肌梗死(STEMI)患者的冠状动脉血栓闭塞常伴有血栓质量的进行性生长。类似于伤口愈合,血栓的组织可能依赖于微血管的生长以稳定其结构。我们研究了不同阶段冠状动脉血栓演变过程中的新生血管形成模式。

材料和方法

根据血栓年龄将从 STEMI 患者中获得的血栓切除术材料分为三组:新鲜(<1 天)、溶解(1-5 天)或已形成(>5 天)血栓。每组随机收集 40 个血栓。通过组织形态学和免疫双染来评估血栓中的新生血管化,以可视化内皮细胞(EC)和原始细胞的各种分化抗原。

结果

形态学上,冠状动脉血栓中的 EC 表现为:单个细胞、细胞簇或微血管。所有血栓中均存在 98%的 CD31+/CD34+EC。此外,在<1 天的新鲜血栓中发现 63%的内皮细胞簇。所有阶段均观察到 CD105+、Ki67+或 C-kit+EC(活跃增殖细胞),但在已形成(>5 天)血栓中明显多于新鲜和溶解(<5 天)血栓,且主要为细胞簇(所有 P 值均≤0.05)。仅在 11%的所有样本中偶然发现 CD133+原始细胞。

结论

EC 增殖在冠状动脉斑块破裂后血栓形成的组织过程中很早就开始,并逐渐进展,而在这个过程中原始细胞的贡献有限。

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