中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
2期
146-152
,共7页
于熙滢%周大亮%郝丹%魏林%于波
于熙瀅%週大亮%郝丹%魏林%于波
우희형%주대량%학단%위림%우파
动脉粥样硬化%体层摄影术,光学相干%颈动脉狭窄%巨噬细胞
動脈粥樣硬化%體層攝影術,光學相榦%頸動脈狹窄%巨噬細胞
동맥죽양경화%체층섭영술,광학상간%경동맥협착%거서세포
Atherosclerosis%Tomography,optical coherence%Carotid stenosis%Macrophages
目的 评价光学相干断层成像(OCT)在检测兔粥样硬化斑块中巨噬细胞含量的应用价值.方法 选取30只雄性纯种的新西兰大白兔,将动物顺序编号标记,按抽签法随机分为3组:对照组(n=10)、高脂喂养组(n=10)和球囊损伤+高脂组(n=10).对照组给予普通饲料,每日每只100 g,自由饮水,喂养12周.高脂喂养组和球囊损伤+高脂组供给致动脉粥样硬化饲料(由普通颗粒饲料+ 15 g/L胆固醇+100 g/L猪油+150 g/L蛋黄粉组成).球囊损伤+高脂组喂饲致动脉粥样硬化饲料2周后行颈总动脉内膜球囊拉伤术,术后继续喂饲致动脉粥样硬化饲料10周.3组兔喂养12周后分别给予中国斑点蝰蛇毒和组胺药物触发,诱发斑块破裂及血栓形成后进行OCT成像,并与组织学结果对照检测成像效果.结果 (1) OCT和病理测量结果对比:Movat染色与OCT对比显示弹性动脉内膜厚度为[(15.2±0.9)μm比(20.2±7.6) μm],中膜厚度为[(434.2±86.5)μm比(453.8±87.2) μm],斑块厚度为[(330.2±87.1)μm比(392.2±134.5) μm],纤维帽厚度为[(58.3±5.6)μm比(61.2±4.9)μm];上述2种检测方法比较,差异均无统计学意义(P＞0.05).(2)OCT测量巨噬细胞密度的信号强度标准差(NSD)与免疫组织化学结果对比:高脂喂养组纤维帽中的OCT信号强度与周围组织具有同质性,CD68巨噬细胞阳性染色面积百分比＜10％.巨噬细胞OCT原始数据NSD测量与CD68免疫组织化学染色相关(r=0.846,P＜0.01),巨噬细胞OCT对数数据NSD测量与CD68免疫组织化学染色相关(r=0.646,P＜0.05).球囊损伤+高脂组纤维帽中OCT信号强度与周围组织具有明显异质性.CD68巨噬细胞阳性染色面积百分比＞10％,巨噬细胞OCT原始数据NSD测量与CD68免疫组织化学染色结果高度相关(r=0.906,P＜0.01),巨噬细胞OCT对数数据NSD测量与CD68免疫组织化学染色相关(r=0.593,P＜0.05).(3)分析OCT的原始数据及对数数据显示,OCT的原始数据NSD界限为7.12％ ～7.35％时,识别CD68染色＞10％的纤维帽灵敏度和特异度为100％(Kappa值=1.0).分析OCT的对数数据,OCT的NSD界限为7.81％ ～ 7.92％时,识别CD68染色＞10％的纤维帽灵敏度为70％,特异度为75％(Kappa值=0.47).结论 OCT可以识别兔粥样硬化斑块纤维帽中的巨噬细胞含量以评价斑块的易损性.
目的 評價光學相榦斷層成像(OCT)在檢測兔粥樣硬化斑塊中巨噬細胞含量的應用價值.方法 選取30隻雄性純種的新西蘭大白兔,將動物順序編號標記,按抽籤法隨機分為3組:對照組(n=10)、高脂餵養組(n=10)和毬囊損傷+高脂組(n=10).對照組給予普通飼料,每日每隻100 g,自由飲水,餵養12週.高脂餵養組和毬囊損傷+高脂組供給緻動脈粥樣硬化飼料(由普通顆粒飼料+ 15 g/L膽固醇+100 g/L豬油+150 g/L蛋黃粉組成).毬囊損傷+高脂組餵飼緻動脈粥樣硬化飼料2週後行頸總動脈內膜毬囊拉傷術,術後繼續餵飼緻動脈粥樣硬化飼料10週.3組兔餵養12週後分彆給予中國斑點蝰蛇毒和組胺藥物觸髮,誘髮斑塊破裂及血栓形成後進行OCT成像,併與組織學結果對照檢測成像效果.結果 (1) OCT和病理測量結果對比:Movat染色與OCT對比顯示彈性動脈內膜厚度為[(15.2±0.9)μm比(20.2±7.6) μm],中膜厚度為[(434.2±86.5)μm比(453.8±87.2) μm],斑塊厚度為[(330.2±87.1)μm比(392.2±134.5) μm],纖維帽厚度為[(58.3±5.6)μm比(61.2±4.9)μm];上述2種檢測方法比較,差異均無統計學意義(P＞0.05).(2)OCT測量巨噬細胞密度的信號彊度標準差(NSD)與免疫組織化學結果對比:高脂餵養組纖維帽中的OCT信號彊度與週圍組織具有同質性,CD68巨噬細胞暘性染色麵積百分比＜10％.巨噬細胞OCT原始數據NSD測量與CD68免疫組織化學染色相關(r=0.846,P＜0.01),巨噬細胞OCT對數數據NSD測量與CD68免疫組織化學染色相關(r=0.646,P＜0.05).毬囊損傷+高脂組纖維帽中OCT信號彊度與週圍組織具有明顯異質性.CD68巨噬細胞暘性染色麵積百分比＞10％,巨噬細胞OCT原始數據NSD測量與CD68免疫組織化學染色結果高度相關(r=0.906,P＜0.01),巨噬細胞OCT對數數據NSD測量與CD68免疫組織化學染色相關(r=0.593,P＜0.05).(3)分析OCT的原始數據及對數數據顯示,OCT的原始數據NSD界限為7.12％ ～7.35％時,識彆CD68染色＞10％的纖維帽靈敏度和特異度為100％(Kappa值=1.0).分析OCT的對數數據,OCT的NSD界限為7.81％ ～ 7.92％時,識彆CD68染色＞10％的纖維帽靈敏度為70％,特異度為75％(Kappa值=0.47).結論 OCT可以識彆兔粥樣硬化斑塊纖維帽中的巨噬細胞含量以評價斑塊的易損性.
목적 평개광학상간단층성상(OCT)재검측토죽양경화반괴중거서세포함량적응용개치.방법 선취30지웅성순충적신서란대백토,장동물순서편호표기,안추첨법수궤분위3조:대조조(n=10)、고지위양조(n=10)화구낭손상+고지조(n=10).대조조급여보통사료,매일매지100 g,자유음수,위양12주.고지위양조화구낭손상+고지조공급치동맥죽양경화사료(유보통과립사료+ 15 g/L담고순+100 g/L저유+150 g/L단황분조성).구낭손상+고지조위사치동맥죽양경화사료2주후행경총동맥내막구낭랍상술,술후계속위사치동맥죽양경화사료10주.3조토위양12주후분별급여중국반점호사독화조알약물촉발,유발반괴파렬급혈전형성후진행OCT성상,병여조직학결과대조검측성상효과.결과 (1) OCT화병리측량결과대비:Movat염색여OCT대비현시탄성동맥내막후도위[(15.2±0.9)μm비(20.2±7.6) μm],중막후도위[(434.2±86.5)μm비(453.8±87.2) μm],반괴후도위[(330.2±87.1)μm비(392.2±134.5) μm],섬유모후도위[(58.3±5.6)μm비(61.2±4.9)μm];상술2충검측방법비교,차이균무통계학의의(P＞0.05).(2)OCT측량거서세포밀도적신호강도표준차(NSD)여면역조직화학결과대비:고지위양조섬유모중적OCT신호강도여주위조직구유동질성,CD68거서세포양성염색면적백분비＜10％.거서세포OCT원시수거NSD측량여CD68면역조직화학염색상관(r=0.846,P＜0.01),거서세포OCT대수수거NSD측량여CD68면역조직화학염색상관(r=0.646,P＜0.05).구낭손상+고지조섬유모중OCT신호강도여주위조직구유명현이질성.CD68거서세포양성염색면적백분비＞10％,거서세포OCT원시수거NSD측량여CD68면역조직화학염색결과고도상관(r=0.906,P＜0.01),거서세포OCT대수수거NSD측량여CD68면역조직화학염색상관(r=0.593,P＜0.05).(3)분석OCT적원시수거급대수수거현시,OCT적원시수거NSD계한위7.12％ ～7.35％시,식별CD68염색＞10％적섬유모령민도화특이도위100％(Kappa치=1.0).분석OCT적대수수거,OCT적NSD계한위7.81％ ～ 7.92％시,식별CD68염색＞10％적섬유모령민도위70％,특이도위75％(Kappa치=0.47).결론 OCT가이식별토죽양경화반괴섬유모중적거서세포함량이평개반괴적역손성.
Objective To evaluate the feasibility of detecting macrophage content on atherosclerotic plaques by optical coherence tomography (OCT) technique.Methods Thirty New Zealand white rabbits were equally divided into 3 groups at random:Control group(fed normal rabbit chow,n =10);lipid diet group(fed regular chow supplemented with cholesterol,n =10)and balloon injury + lipid diet group (balloon catheter injury of the common carotid artery after 2 weeks lipid diet,n =10).After 12 weeks,all rabbits underwent pharmacological triggering with Chinese Russell's viper venom (CRVV,15 mg/kg,i.p.) and histamine (0.02 mg/kg,i.v.).Common carotid arteries were detected with OCT and the Movat pentachrome stain respectively.OCT and histological examination results were compared and the correlation was analyzed.Results The intra thickness measured by Movat pentachrome stain and by the OCT was (15.2 ± 0.9) μm and (20.2 ± 7.6) μm,the medial thickness was (434.2 ± 86.5) μm and (453.8 ± 87.2) μm,the plaque thickness was (330.2 ± 87.1) μm and (392.2 ± 134.5) μm,the fibrous cap thickness was (58.3 ± 5.6) μm and (61.2 ± 4.9) μm,respectively (all P ＞ 0.05).The normalized standard deviation of the OCT signal (NSD) was compared with immunohistochemical detection.The OCT signal within the cap is relatively homogeneous for low macrophage density in high lipid diet group.For the raw OCT data,a correlation of r =0.846 (P ＜ 0.01) was found between OCT NSD and a CD68 area ＜ 10％,whereas for the base 10 logarithm OCT data,a correlation of r =0.646 (P ＜ 0.05) was found between OCT NSD and a CD68 area ＜ 10％.In balloon injury + high lipid diet group,the OCT signal within the cap was relatively heterogeneous for high macrophage content.For the raw OCT data,a correlation of r =0.906 (P ＜ 0.01) was found between OCT NSD and a CD68 area ＞ 10％,whereas for the base 10 logarithm OCT data,a correlation of r =0.593 (P ＜0.05) was found between OCT NSD and a CD68 area ＞ 10％.For the raw OCT signal NSD,a range of NSDs (7.12％ to 7.35％) demonstrated 100％ sensitivity and specificity (Kappa value 1.0) for differentiating caps containing ＞ 10％ CD68 staining.For the base 10 logarithm OCT signal,NSD values ranging from 7.81％ to 7.92％ provided 70％ sensitivity and 75％ specificity (value 0.44) for identifying caps containing ＞ 10％ CD68 staining.Conclusions OCT is an effective tool to determine macrophage content in this model.OCT imaging can clearly visualize different types of atherosclerotic plaques and provide detailed information on plaque characteristics.
