血小板衍化生长因子及其受体在糖尿病下肢动脉硬化闭塞症中的表达及意义

摘要

目的 探讨2型糖尿病伴下肢动脉硬化闭塞症(arteriosclerosis obliterans，ASO)动脉硬化斑块中血小板衍化生长因子(platelet-derived growth factor,PDGF)及其受体(PDGFR)的表达及意义。方法 2007年1月至2009年12月复旦大学附属中山医院血管外科行介入治疗或手术治疗的ASO患者共22例，其中合并2型糖尿病者13例，无糖尿病者9例。共获取动脉硬化标本27个。对行手术治疗的ASO患者留取动脉内膜斑块，分别进行苏木精-伊红(HE)染色及免疫组化染色，通过光学显微镜了解PDGFR-α和PDGFR-β在动脉硬化标本中的表达。RT-PCR法检测PDGF A、B链mRNA。结果 无糖尿病的ASO患者下肢动脉硬化斑块经HE染色可见少量脂质浸润，免疫组化染色见PDGFR-α、β少量表达；2型糖尿病伴下肢ASO患者下肢动脉硬化斑块，HE染色可见大量脂质浸润，免疫组化染色可见PDGFR-α、β均大量表达。2型糖尿病伴下肢ASO患者髂、股动脉段动脉硬化标本中PDGF B链mRNA的表达远远高于其在无糖尿病者中的表达，PDGF B链在胭动脉段的表达较髂、股动脉段明显增加。结论 2型糖尿病伴ASO患者下肢动脉硬化标本中存在PDGFR-α、β高表达，胭动脉标本中PDGF B链数量增多，提示该因子在此类患者中的病情进展中发挥重要作用。%Objective To explore the expression of platelet-derived growth factor (PDGF) and its receptors in arteriosclerosis plaque on type 2 diabetes mellitus (T2DM) combined with arteriosclerosis obliterans (ASO) of lower extremity. Methods From Jan. 2007 to Sept. 2009, there were 22 patients with ASO received interventional therapy or surgical operation in Zhongshan Hospital, Fudan University, among which 13 cases were combined with T2DM. We obtained 27 samples of arteriosclerotic plaques from these patients. One part of samples were dyed with HE and immunohistochemical staining to research on PDGF receptor (PDGFR), the others were detected for A and B chain mRNA expressions of PDGF by RT-PCR. Results A little lipid invasion was found in the samples of femoral arteriosclerosis plaques from ASO patients without T2DM by HE staining, and a few PDGFR - α and β was expressed in femoral arteriosclerosis plaques by immunohistochemistry staining.However, large expression of lipid invasion under HE stain as well as PDGF-α and β under immuno-histochemistry stain was found in ASO patients with T2DM. The quantity of PDGF-β chain mRNA was significantly increased in T2DM pactients compared with patients without T2DM. The mean quantity of PDGF B chain mRNA popliteal arteriosclerosis plaques of ASO patients with T2DM was increased significantly compared with the in iliac or femoral arteriosclerosis plaques of ASO patients without T2DM. Conclusions PDGFR-α and β was over-expressed in peripheral artery occlude diseases combined with T2DM, which explored that it is critical in the development of arterioclerosis. PDGF B chain mRNA expression were higher in popliteal arteriosclerosis plaques of ASO patients with T2DM than in their iliac or femoral artery plaques, which explored that it plays a key role in the development of arteriosclerosis.