Kita Y, Nakamura K, Itoh H
First Department of Pathology, Kobe University School of Medicine, Japan.
Acta Pathol Jpn. 1990 Jun;40(6):408-16. doi: 10.1111/j.1440-1827.1990.tb01580.x.
We studied the histologic and histometric features of the aortic media in cases of dissecting aneurysm in order to clarify the pathologic background of this condition. The results were then compared with cases of true aneurysm and control specimens of "normal" aging aorta. Most cases of dissecting aneurysm and true aneurysm, as well as a number of control specimens, showed severe cystic medial necrosis, and therefore this feature does not appear to be specific to dissecting aneurysm. Fibrosis was noted in the process of repair of medionecrosis in dissecting aneurysm, true aneurysm, and controls. The main pathologic features of the aortic media in dissecting aneurysm included a higher grade of elastin fragmentation (offensive factor) and less fibrosis (defensive factor). Our findings indicate that the pathologic balance between these offensive and defensive factors is an important consideration when evaluating the pathogenesis of dissecting aneurysm.
我们研究了夹层动脉瘤病例中主动脉中膜的组织学和组织计量学特征，以阐明这种疾病的病理背景。然后将结果与真性动脉瘤病例以及“正常”衰老主动脉的对照标本进行比较。大多数夹层动脉瘤和真性动脉瘤病例，以及一些对照标本，均显示出严重的囊性中膜坏死，因此该特征似乎并非夹层动脉瘤所特有。在夹层动脉瘤、真性动脉瘤和对照标本的中膜坏死修复过程中均观察到纤维化。夹层动脉瘤中主动脉中膜的主要病理特征包括更高程度的弹性蛋白断裂（攻击因素）和更少的纤维化（防御因素）。我们的研究结果表明，在评估夹层动脉瘤的发病机制时，这些攻击和防御因素之间的病理平衡是一个重要的考量因素。
