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目的 观察壁冠状动脉及其近段内皮细胞形态和内皮下组织特征 ,探讨心肌桥导致的血流动力学变化对动脉粥样硬化形成的影响。方法 用肝素 -生理盐水和 4%戊二醛溶液冲洗 4例有心肌桥的新鲜人尸左冠状动脉 ,取壁冠状动脉近段、壁冠状动脉段、壁冠状动脉远段 ,扫描电镜观察其血管内皮细胞和基膜特征。结果 冠状动脉近段内皮细胞多呈扁平状或卵圆形 ,表面粗糙 ,有“虫啄样”缺损 ,细胞容易脱落。壁冠状动脉内皮细胞呈细长梭形 ,表面可有微绒毛和桥样结构 ,壁冠状动脉内皮细胞的形态指数低于其近段和远段的形态指数。结论 壁冠状动脉内皮细胞受到心肌桥压迫导致血流切变力增高产生适应性反应 ,对内皮细胞有保护作用 ,而其近段内皮细胞由于切变力较低容易被损伤 ,成为动脉粥样硬化发生的基础。
Objective To observe the morphology of endothelial cells and the characteristics of subendothelial tissue in the proximal coronary arteries and to investigate the effect of myocardial bridge-induced hemodynamic changes on the formation of atherosclerosis. Methods The fresh corpse of the left coronoid artery with myocardial bridge was washed with heparin-saline and 4% glutaraldehyde solution. The coronaries of the proximal wall, the wall of the coronary artery and the wall of the coronary artery were collected. The blood vessels were observed by scanning electron microscopy Endothelial cells and basement membrane features. Results Most of the proximal coronary artery endothelial cells were flat or oval, with rough surface. There were “pests pecking” defects and the cells could fall off easily. Wall coronary artery endothelial cells were elongated fusiform, the surface may have microvilli and bridge-like structure, the shape index of the wall coronary artery endothelial cells than its proximal and distal morphological index. CONCLUSIONS: Wall coronary artery endothelial cells are induced by myocardial bridge and lead to the increase of shear force of blood flow to produce adaptive reaction, which has a protective effect on endothelial cells. However, the endothelial cells in the proximal segment are easy to be injured due to the lower shear force and become atherosclerosis The basis of what happened.