摘要
目的研究妊娠合并主动脉夹层患者动脉壁的病理改变特征,探究妊娠与非妊娠主动脉夹层患者主动脉病理学表现差异。方法收集2012—2019年28例妊娠合并主动脉夹层患者作为妊娠组,选择同时期接受主动脉修复治疗的20~40岁非妊娠女性主动脉夹层患者共93例作为对照组,收集其临床及病理资料,通过HE、免疫组化以及特殊染色对所送检主动脉标本各成分进行分级诊断。结果(1)妊娠组患者年龄22~36岁,平均年龄为(28.96±3.90)岁。发病时间为妊娠8周至产后11天。(2)主动脉夹层对动脉壁平滑肌细胞及弹力纤维均造成了损伤,包括断裂、缺失等改变。(3)弹力纤维排列紊乱程度在两组中的差异有统计学意义(P<0.05),妊娠组77.78%的病例不存在排列紊乱,但对照组有40.45%伴有轻度排列紊乱。结论主动脉夹层患者病理学表现相似,都会出现弹力纤维及平滑肌细胞损伤且多表现为重度,但妊娠组患者动脉壁内残存弹力纤维相较对照组而言更不易出现排列紊乱。
Objective To explore the pathological changes of the aortic wall from pregnant women with aortic dissection,and to explore the differences in aortic pathology between pregnant and non-pregnant patients with aortic dissection.Methods A total of 28 patients with aortic dissection during pregnancy from 2012 to 2019 were collected as the pregnancy group,and a total of 93 non-pregnant women aged 20 to 40 who received aortic repair treatment because of aortic dissection from 2012 to 2019 were selected as control group.The clinical and pathological data of all patients were collected,and the components of the aortic wall were diagnosed by using HE and special stains and immunohistochemistry.Results The age of the pregnancy group ranged from 22 to 36 years,with an average age of(28.96±3.90)years.The onset time ranged from 8 weeks of pregnancy to 11 days after delivery.Aortic dissection had a great effect on smooth muscle cells and elastic fibers of aortic wall,including fragmentation and loss.The degree of elastic fiber disorganization was statistically significant in the pregnancy group and the control group(P<0.05).77.78%of the cases in the pregnancy group were not accompanied by elastic fiber disorganization,but 40.45%of the cases in the control group were accompanied by mild disorganization.Conclusion The pathological manifestations of patients with aortic dissection are similar,with injuries of elastic fibers and smooth muscle cells and most of them are severe.However,the remaining elastic fibers in the artery wall of the pregnancy group are less prone to arrangement disorders than those in the control group.
作者
赵艳丽
郑梦晗
陈东
汪昊
张睿祺
方微
商建峰
ZHAO Yan-li;ZHENG Meng-han;CHEN Dong;WANG Hao;ZHANG Rui-qi;FANG Wei;SHANG Jian-feng(Department of Pathology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《诊断病理学杂志》
2023年第5期428-432,共5页
Chinese Journal of Diagnostic Pathology
关键词
妊娠
主动脉夹层
中膜变性
Pregnancy
Aortic dissection
Medial degeneration
作者简介
通讯作者:陈东。E-mail:azchendong@163.com
