Yutani C, Imakita M, Ishibashi-Ueda H
Division of Pathology, National Cardiovascular Center, Suita, Japan.
Acta Pathol Jpn. 1989 Jul;39(7):425-32. doi: 10.1111/j.1440-1827.1989.tb02457.x.
A histopathological study was performed on 36 patients (60 grafts) who had undergone aorto-coronary bypass graft (ACBG) surgery 0 to 99 months prior to death. The following pathologic changes were found: 1) The thickness of diffuse intimal proliferation in the ACBG progressed with time from graft surgery to death. 2) The media became atrophic and the adventitia was increased slightly in thickness. 3) Fibrin deposits were found in 20 patients on/in the intimal thickenings of the vein graft walls and 7 patients showed incorporated fibrin in the thickened intima even one month after surgery. 4) Atherosclerosis, identified as intimal foam cell accumulation or frank plaques, was seen in only 3 patients 4 years after surgery. Fibrointimal proliferation occurred with relatively greater frequency in patients with fibrin deposits (P less than 0.001). Although it is well known that mural thrombi in vein grafts manifest fibrointimal proliferation, our results suggest that fibrin deposits might be responsible for intimal thickening even one month after graft surgery.
对36例患者（60处移植物）进行了组织病理学研究，这些患者在死亡前0至99个月接受了主动脉冠状动脉旁路移植术（ACBG）。发现了以下病理变化：1）ACBG中弥漫性内膜增生的厚度从移植手术到死亡随时间进展。2）中膜萎缩，外膜厚度略有增加。3）在20例患者的静脉移植物壁内膜增厚处发现纤维蛋白沉积，7例患者甚至在术后1个月时增厚内膜中可见融合的纤维蛋白。4）仅在术后4年的3例患者中发现动脉粥样硬化，表现为内膜泡沫细胞积聚或明显斑块。纤维蛋白沉积患者中纤维内膜增生的发生频率相对较高（P小于0.001）。虽然众所周知静脉移植物中的壁血栓会表现出纤维内膜增生，但我们的结果表明，即使在移植手术后1个月，纤维蛋白沉积也可能是内膜增厚的原因。
