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目的 :研究动脉粥样硬化 (AS)病灶中细胞凋亡的发生情况及其相关基因的表达情况 ,探讨细胞凋亡与bcl 2、p5 3、C myc基因表达的内在联系。方法 :选择因AS住院手术患者 2 0例作为研究对象〔其中男 17例 ,女 3例 ,平均年龄 (6 6 .8± 9.86 )岁 ,主要取患者的股动脉〕 ,及因意外伤害手术患者的 10例〔其中男 8例 ,女 2例 ,平均年龄 (5 1.6± 11.97)岁〕作为正常对照。采用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记 (TUNEL)技术检测两组动脉标本的细胞凋亡情况 ,采用免疫组化的方法检测bcl 2、p5 3及C myc基因的表达情况 ,应用透射电镜进行两组动脉标本的细胞形态学观察。结果 :AS病灶中 ,细胞凋亡的发生率明显高于正常对照血管 (P <0 .0 1) ,bcl 2蛋白的表达明显降低 ,p5 3蛋白及C myc蛋白的表达明显升高 (P <0 .0 1) ;透射电镜证实AS病灶中有大量的平滑肌细胞发生凋亡。结论 :细胞凋亡是AS病灶中细胞死亡的一种主要形式 ,bcl 2、p5 3及C myc基因的表达可能对细胞凋亡的发生起重要的调控作用。
OBJECTIVE: To study the occurrence of apoptosis and the expression of its related genes in atherosclerotic lesions and to explore the relationship between apoptosis and expression of bcl-2, p5 and C-myc genes. Methods: A total of 20 hospitalized patients undergoing AS surgery were selected as the study subjects (including 17 males and 3 females, mean age (66.88 ± 9.86) years old, mainly femoral arteries) and patients with accidental injuries Of the 10 cases 〔including 8 males and 2 females, mean age (5 1.6 ± 11.97) years old〕 as a normal control. The apoptosis of the two groups of arteries was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL). The expressions of bcl 2, p5 3 and C myc were detected by immunohistochemistry. Transmission electron microscopy was used to observe the morphology of two groups of arterial cells. Results: The incidence of apoptosis in AS lesions was significantly higher than that in normal controls (P <0.01), the expression of bcl 2 protein was significantly decreased, and the expressions of p5 3 protein and C-myc protein were significantly increased (P < 0 .0 1); Transmission electron microscopy confirmed a large number of AS lesions in the apoptosis of smooth muscle cells. CONCLUSIONS: Apoptosis is a major form of cell death in AS lesions. The expression of bcl 2, p5 3 and C myc genes may play an important role in the regulation of apoptosis.