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目的探讨早期雌激素替代疗法对去卵巢家兔动脉粥样硬化病变的影响。方法36只雌性新西兰大白兔随机分成假手术组(A组)、对照组(B组)和雌激素组(C组),每组12只,各组均进食含1.5%胆固醇的高脂饲料。A组不去卵巢,B组和C组均去卵巢,A组、B组均给予安慰剂,C组给予小剂量雌激素(戊酸雌二醇2 mg/周),饲养12周后均切开股动脉后取血,并取全长的主动脉。分别检测血液学指标,光镜下观察组织病理。取主动脉根部5 mm标本进行切片(横切面):HE染色,观察横切面动脉硬化病变的内膜/中膜厚度比值;苦味酸天狼星红染色,观察斑块内胶原纤维的含量,免疫组化法半定量观察横切面斑块内巨噬细胞的阳性率。其余部分从胸主动脉起始部到腹主动脉分叉处纵行剖开,油红O染色,分析纵剖面斑块面积及占主动脉的面积比。结果无论是横切面HE染色的内膜/中膜厚度比,还是纵剖面油红O染色的动脉粥样硬化斑块面积及占主动脉的面积之比,A、C组都明显小于B组(P<0.05),C组斑块内巨噬细胞的阳性率明显低于B组(P<0.05),但C组斑块内胶原纤维的含量多于B组(P<0.05)。结论早期雌激素替代治疗可改善血脂代谢,减少斑块内巨噬细胞的数量,增加斑块内胶原纤维的含量,稳定斑块,可能是通过这些作用抑制了动脉粥样硬化斑块的进展。
Objective To investigate the effect of early estrogen replacement therapy on the atherosclerosis in ovariectomized rabbits. Methods Thirty - six female New Zealand white rabbits were randomly divided into sham operation group (A group), control group (B group) and estrogen group (C group) with 12 rats in each group. All groups were fed with high fat diet containing 1.5% cholesterol. Ovariectomized in group A, ovariectomized in group B and group C, placebo in group A and group B, and estrogen (estradiol valerate 2 mg / week) in group C, Arterial blood, and take the full length of the aorta. Hematological parameters were detected, and histopathology was observed under light microscope. The aortic root specimens of 5 mm were sectioned (transverse section): HE staining to observe the intima / media thickness ratio of transverse section atherosclerosis lesions; picric acid Sirius red staining to observe the content of collagen fibers in the plaque, immunohistochemistry Semi-quantitative semi-quantitative observation of cross-section plaque macrophage positive rate. The rest was dissected longitudinally from the beginning of the thoracic aorta to the bifurcation of the abdominal aorta. Oil red O staining was performed to analyze the area of the longitudinal section plaque and the area ratio of the aorta. Results Both the intima / media thickness ratio of transverse section HE staining and the area of atherosclerotic plaque in the longitudinal section of oil red O stained and the area of the aorta were significantly smaller in group A and C than in group B P <0.05). The positive rate of macrophages in plaque in group C was significantly lower than that in group B (P <0.05). However, the content of collagen fibers in plaque in group C was more than that in group B (P <0.05). Conclusion Early estrogen replacement therapy can improve blood lipid metabolism, reduce the number of macrophages in the plaque, increase the content of collagen fibers in the plaque, and stabilize the plaque. These effects may inhibit the development of atherosclerotic plaque.