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[风湿性疾病二尖瓣及心脏间质Ⅰ、Ⅲ、Ⅳ型胶原的病理观察与免疫组化研究]

[Pathological observation and immunohistochemistry study of Type I, III, IV collagen in mitral valve and cardiac interstitium of rheumatic disease].

作者信息

Fan H, Liu W, Yan P

机构信息

Xi jing Hospital Fourth Military Medical University Xian.

出版信息

Zhonghua Yi Xue Za Zhi. 1996 Mar;76(3):183-6.

PMID:8758424
Abstract

OBJECTIVES

To examine the pathological base of mitral valve and cardiac interstitium of rheumatic disease, and to explore the relationship between Type I, and III, IV collagen in mitral and cardiac interstitium of rheumatic heart disease.

METHODS

HE and ABC method special staining were used to observe the mitral valve and cardiac interstitium pathology in 26 case.

RESULTS

Diffused collagen fibroplasia, hyaline and amyloid degeneration were noted and sometimes associated local necrosis and calcification in myocardial interstitium and in mitral valve. It was a significant pathologic characteristic of rheumatic heart disease. The localization of Type I, III and IV collagen in the valve and myocardiac tissues was studied by ABC method of immunohistochemistry. Significant fibroplasia of collagen Type I and III was found in the valve, cordae tendon and myocardial interstitium of rheumatic heart disease. The composition and secretion of collagen Type I and III were expressed not only in fibroblasts but also in myocardial cells.

CONCLUSIONS

The pathologic foundation of valve and myocardial fibrosis is collagen fibroplasia. The degree of fibroplasia is related to the repeated reaction of chronic rheumatic inflammation.

摘要

目的

研究风湿性疾病二尖瓣及心脏间质的病理基础,探讨风湿性心脏病二尖瓣及心脏间质中Ⅰ型、Ⅲ型和Ⅳ型胶原之间的关系。

方法

采用HE染色及ABC法特殊染色观察26例患者的二尖瓣及心脏间质病理变化。

结果

心肌间质及二尖瓣可见弥漫性胶原纤维增生、玻璃样变性及淀粉样变性,有时伴有局部坏死及钙化,这是风湿性心脏病的重要病理特征。采用免疫组织化学ABC法研究瓣膜及心肌组织中Ⅰ型、Ⅲ型和Ⅳ型胶原的定位。风湿性心脏病患者的瓣膜、腱索及心肌间质中可见明显的Ⅰ型和Ⅲ型胶原纤维增生。Ⅰ型和Ⅲ型胶原的合成与分泌不仅在成纤维细胞中表达,心肌细胞中也有表达。

结论

瓣膜及心肌纤维化的病理基础是胶原纤维增生。纤维化程度与慢性风湿性炎症的反复反应有关。

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