【摘要】 目的:观察血管瘤及血管畸形铜针治疗后瘤体内皮细胞凋亡情况及组织病理学改变。方法:①选择2003-01/2005-12广西医科大学第一附属医院整形美容外科就诊的血管瘤及血管畸形患者15例,男7例,女8例。均对治疗方案知情同意。②选工业用直径1.0～2.0mm,长5～10cm铜丝,一端打磨成尖,另一端弯成圆形的铜针,灭菌备用。所有患者均在麻醉下行瘤体局部留置铜针治疗,留置铜针16～45枚,留置时间为1周。③采用原位末端标记法,参照罗氏公司细胞凋亡检测试剂盒说明书检测治疗前后内皮细胞凋亡情况,OLYMPUS光学显微镜下观察,细胞核被染成红棕色的细胞视为凋亡细胞。每例切片高倍镜(×400)下随机观察10个视野,每个视野计数100个血管内皮细胞,计数其中阳性细胞数,计算凋亡指数(染色阳性细胞数/计数细胞总数×100%)。OLYMPUS光学显微镜下观察(×400)治疗前后组织病理变化。④治疗前后计量资料差异比较采用配对t检验。结果:血管瘤及血管畸形患者15例均进入结果分析。①血管内皮细胞凋亡情况:铜针治疗后血管内皮细胞凋亡指数高于治疗前,但差异不明显[(0.21±0.15)%,(0.17±0.10)%,P>0.05]。②组织病理学变化:治疗前瘤体血管普遍呈囊状不规则扩张,管腔大小不一;治疗后多数样本出现组织坏死、血栓形成、伴有慢性炎症反应,血管腔明显缩小,管壁增厚,部分出现纤维化及肉芽形成。结论:铜针治疗后血管瘤和血管畸形内皮细胞凋亡情况无明显变化,但出现了血管内膜炎、血栓形成、瘤体纤维化。更多还原

【Abstract】 AIM: To investigate the effect of copper needles retained in hemangioma and vascular malformation on endothelial cells apoptosis as well as histological and pathological changes of the neoplasm. METHODS: ①Between January 2003 and December 2005, 15 cases with hemangioma or vascular malformation were selected from the Department of Plastic and Cosmetic Surgery, First Affiliated Hospital of Guangxi Medical University, including 7 males and 8 females. All cases understood and agreed to their treatments. ②The copper needles, ranging from 5 cm to 10 cm in length with a blunt point and a circularity end, which were made of industrial copper wire with diameter from 1.0 mm to 2.0 mm were sterilized before use. All cases were retained 16-45 copper needles in the local hemangioma and vascular malformation under anaesthesia for one week. ③In situ end-labeling (ISEL) was used in the light of instruction of Roche apoptosis kit to detect the apoptotic endothelial cells. The cells with brown karyon stained were deemed to be apoptotic cell under Olympus light microscope. 10 high power fields of vision (×400) from each slice up and 100 vascular endothelial cells in each eyeshot were chosen randomly to count the positive cell stained and the apoptosis index (positive cell stained/total endothelial cells counted ×100%). The histological and pathological changes were observed under Olympus light microscope (×400). ④The paired t test was applied to compare the difference of measurement data after treatment with that one before treatment. RESULTS: All the 15 cases with hemangioma or vascular malformation were involved in the result analysis. ①Vascular endothelial cells apoptosis: The apoptosis index of vascular endothelial cells after copper needles treatment was higher than that before copper needles treatment, but with no significant difference between each other (0.21±0.15)%,(0.17±0.10)%,P > 0.05. ②Histological and pathological changes: Before treatment, the blood vessels of neoplasm presented universally irregular and cystoid distention with varied diameter. However, tissue necrosis, thrombogenesis, associated with chronic inflammatory reaction, dwindling of blood vessel and vessel wall thickening appeared in most specimens after copper needles treatment. Fibrosis and granulomas could be seen in some specimens. CONCLUSION: Copper needles retained in hemangioma and vascular malformation do not arouse significant change of endothelial cells apoptosis, but lead to endangeitis, thrombogenesis and fibrosis of the neoplasm.更多还原