关键词: 动静脉畸形; 病理结构; 内皮素-1

Abstract:

Objective To observe the pathological features of brain arteriovenous malformations(AVMs) and semiquantitatively measure the levels of endothelin-1(ET-1) in the blood vessels of AVMs in order to investigate the relationship between ET-1 and the rupture of AVMs. Methods Thirty-one patients diagnosed as AVMs were divided into ruptured group(n=15) and unruptured group(n=16). Our study had included the control group(the normal blood vessel excised from the other craniocerebral operation). The tissues of the blood vessel cut from the AVMs and the normal blood vessel were stained with Masson trichrome(collagen fibers) to evaluate the vessel-wall structure and endothelial integrity. Immunohistochemical staining was semiquantitatively performed to detect the content and distribution of ET-1 in the vessel wall and the differences among those three groups had been compared. Results The Masson trichrome staining demonstrated that the endothelial cells were damaged, smooth muscle cells were degenerated, and collagen fibers were proliferated in the media in the unruptured group. While in the ruptured group, the endothelium of blood vessel was severely damaged, the smooth muscle was obviously reduced, and almost was replaced by the collagen fibers. Mean grayscale intensity of ET-1 in the control group, non-ruptured group and ruptured group was 0.167±0.004, 0.196±0.007 and 0.231±0.012, respectively. The semi-quantitative study on vascular endothelial related factors found that ET-1 in ruptured group was significantly higher than that in unruptured group(P=0.019) and control group(P<0.001 ), and ET-1 in unruptured group was higher than that in control group(P=0.001 ). Conclusion The vessel walls of AVMs are damaged. The ruptured AVMs are severely damaged. ET-1 is highly expressed in the damaged wall of the AVM.

Key words: Arteriovenous malformations; Pathological structure; Endothelin-1