目的：观察不同静脉管壁在高流体静力压下细胞凋亡变化及机制。 方法：收集高压性病脾静脉（DSV）与曲张大隐静脉（VGSV）标本，分别以正常脾静脉（SV）、正常 大隐静脉（GSV）标本为对照。采用TUNEL、免疫荧光观察静脉管壁细胞凋亡情况，免疫组化检测凋 亡相关蛋白Bax、Bcl-xl 表达，电镜观察超微结构的变化。 结果：与各自的对照比较，DSV 和VGSV 管壁（内膜和中膜）凋亡细胞比率明显降低（均P<0.05）； 促凋亡蛋白Bax 表达减少，抗凋亡蛋白Bcl-xl 表达增加，Bax/Bcl-xl 比值明显降低（均P<0.05）； DSV 和VGSV 的内皮细胞与平滑肌细胞出现线粒体嵴模糊、髓样变、核染色质边集。 结论：不同的静脉管壁在高流体静力压下均存在相同的经线粒体通路细胞凋亡失调，这可能是导致相 关疾病状态下静脉管壁扩张和增厚的重要机制。
Alterations in apoptosis in the wall of splenic vein and great saphenous vein under high hydrostatic pressure
Objective: To investigate the changes in apoptosis of cells in different venous walls under high hydrostatic pressure and the mechanisms. Methods: Samples of portal hypertension induced diseased splenic veins (DSV) and varicose great saphenous veins (VGSV) were collected, and samples of normal splenic veins (SV) and great saphenous veins (GSV) were used as control. The apoptotic cells in the venous walls were detected by TUNEL assay and immunofluorescence staining, the apoptosis-related protein Bax and Bcl-xl expressions were determined by immunohistochemical staining, and the cell ultrastructural changes were observed with an electron microscope. Results: In the wall (intima and media) of the DSV and VGSV compared with respective control, the apoptotic ratio was significantly reduced (both P<0.05); the proapoptotic protein Bax expression was reduced, antipoptotic protein Bcl-xl was elevated and Bax/Bcl-xl ratio was significantly decreased (all P<0.05). The endothelial and smooth muscle cells in the walls of DSV and VGSV exhibited fuzzy mitochondrial cristae, medullary changes, and margination of the nuclear chromatin. Conclusion: Under high hydrostatic pressure, there is a similar dysregulation in mitochondrial pathway of apoptosis in different venous walls, which is probably an important mechanism for venous wall dilation and thickness in relevant disease conditions.