Grüninger B, Schoon H A, Schoon D, Menger S, Klug E
Institut für Veterinär-Pathologie, Universität Leipzig, Germany.
J Comp Pathol. 1998 Oct;119(3):293-309. doi: 10.1016/s0021-9975(98)80051-0.
The morphology of endometrial blood vessels in uterine biopsy specimens from mares of varying age and reproductive status was examined by light (n = 117) and electron microscopy (n = 13), and additionally after elastase digestion (n = 86). Inflammatory vascular alterations were observed in 20.5% of the specimens. Smaller and larger arterial and venous vessels demonstrated mild to severe degenerative lesions. Unaltered vessels were detected only in maiden mares. Vessels in older maiden mares were frequently affected by angiosclerotic changes, characterized by mild to moderate perivascular and intimal sclerosis. The incidence and severity of angiosis increased with the number of previous pregnancies and with advancing age. Changes in multiparous mares resembled the so-called "pregnancy-sclerosis" of other species, with fraying and disruption of the membrana elastica interna, medial atrophy intimal, medial and adventitial elastosis and fibrosis, and calcification processes within the media. Ultrastructural studies revealed characteristic arterial changes in post-parturient mares, namely, disruption of the membrana elastica interna, as well as activated smooth muscle cells and immature elastic fibres within the intima and inner media, suggesting a pregnancy-induced pathogenesis. Haemodynamic and hormonal alterations during pregnancy and the puerperium possibly induce active vascular remodelling. Cycles of vascular growth during pregnancy and subsequent involution post partum are thought to result in progressive degenerative vascular changes, as seen in multiparous mares. Ageing processes, chronic inflammation and short foaling intervals have to be considered as additional pathogenetic factors. Furthermore, severe angiosis was frequently combined with phlebectasia and lymphangiectasia. This may indicate a reduced ability of the vessels to adapt to the varying demands of uterine circulation, with a decrease of uterine perfusion and lymph drainage. Angiosis in older, multiparous mares might therefore be intimately related to infertility.
通过光学显微镜（n = 117）和电子显微镜（n = 13），以及弹性蛋白酶消化后（n = 86），对不同年龄和生殖状态母马子宫活检标本中的子宫内膜血管形态进行了检查。在20.5%的标本中观察到炎症性血管改变。较小和较大的动脉和静脉血管显示出轻度至重度的退行性病变。仅在未生育母马中检测到未改变的血管。年龄较大的未生育母马的血管经常受到血管硬化变化的影响，其特征为轻度至中度的血管周围和内膜硬化。血管病变的发生率和严重程度随着先前怀孕次数的增加和年龄的增长而增加。经产母马的变化类似于其他物种所谓的“妊娠硬化”，表现为内弹性膜磨损和破坏、内膜中层萎缩、中层和外膜弹性组织增生和纤维化，以及中层内的钙化过程。超微结构研究揭示了产后母马动脉的特征性变化，即内弹性膜破坏，以及内膜和内中层内活化的平滑肌细胞和未成熟的弹性纤维，提示发病机制与妊娠有关。妊娠和产褥期的血流动力学和激素改变可能诱导血管的主动重塑。妊娠期间血管生长和产后随后退化的周期被认为会导致渐进性的退行性血管变化，如经产母马中所见。衰老过程、慢性炎症和较短的产驹间隔必须被视为额外的致病因素。此外，严重的血管病变常与静脉扩张和淋巴管扩张合并。这可能表明血管适应子宫循环不同需求的能力降低，子宫灌注和淋巴引流减少。因此，年龄较大的经产母马的血管病变可能与不孕密切相关。
