脂肪因子脂联素、瘦素在退行性瓣膜中的表达特点

摘要

目的：探讨脂肪因子脂联素、瘦素在退行性主动脉瓣的组织表达特点。方法收集2012年10月至2013年10月在海南省人民医院心外科因退行性主动脉瓣疾病行手术切除的主动脉瓣标本30例[男17例，女13例，年龄(55±6)岁]，因夹层动脉瘤行Bentall手术切除正常主动脉瓣标本7例[男性4例，女性3例，年龄(41±8)岁]。经HE和免疫组织化学染色，观察退行性主动脉瓣的组织病理学改变，了解脂肪因子脂联素、瘦素在退行性主动脉瓣的表达特点。结果 HE染色显示，与正常瓣膜比较，损伤的主动脉层内皮下可见大量炎症细胞聚集、纤维组织增生和结节性钙化灶形成，退行性主动脉瓣的厚度不同程度增加[重度(2.80±1.18) mm、中度(2.10±0.09) mm、轻度(0.92±0.13) mm、正常(0.75±0.07) mm]，进一步的分析显示胶原层增厚明显，松质层厚度降低，而心室层无明显改变，免疫组织化学染色显示脂联素在正常瓣膜和退行性主动脉瓣中无表达；瘦素在正常瓣膜无表达，而在退行性主动脉瓣见新生血管以及血管周围有表达。结论退行性主动脉瓣病变中瘦素表达增加。%Objective To investigate the expression of adiponectin and leptin in degenerative aortic valve. Methods The aortic valve specimens from October 2012 to October 2013 were collected in cardiac surgery department of People's Hospital of Hainan Provincial, which included 30 cases of specimens removed from degenerative aortic valve disease [17 cases of males, 13 cases of females, aged (55±6) years old] and 7 cases of normal aortic valve specimens with dissecting aneurysm underwent Bentall operation resection [4 cases of males, 3 cases of females, aged (41±8) years old]. And then the histopathological changes of degenerative aortic valve were observed by HE and immunohistochemical staining to study the expression characteristics of adiponectin and leptin. Results By HE staining, compared with the normal valve, collection of amount of inflammatory cells, fibrous tissue hyperplasia and nodular calcification in injury en-dothelium of aortic layer were noted, and the thickness of degenerative aortic valve increased in varying degrees [severe (2.80±1.18) mm, moderate (2.10±0.09) mm, mild (0.92±0.13) mm, normal (0.75±0.07) mm]. Further analysis showed a increase in the thickness of collagen layer, and a decrease in the thickness of trabecular layer, with no obvious change in the ventricular layer. By immunohistochemical staining, there was no expression of adiponectin in normal and degenera-tive aortic valve and no expression of leptin in normal valve, but the expression of leptin could be observed in and around new vessels of the degenerative aortic valve. Conclusion The expression of leptin increases in degenerative aortic valve.