中文摘要：

本文探讨了下肢动脉硬化闭塞症患者股动脉粥样硬化斑块中巨噬细胞自噬与极化的相互联系。取下肢动脉硬化闭塞症截肢患者的股动脉标本,分别行HE（hematoxylin and eosin）、油红O和免疫荧光染色,观察动脉粥样硬化斑块形态、斑块内巨噬细胞表型及自噬体表达;采用实时荧光定量RT-PCR技术检测动脉组织巨噬细胞M1与M2型标记物的m RNA表达水平;采用Western blot方法检测巨噬细胞极化信号通路及自噬蛋白表达水平。结果显示,动脉标本染色可见明显脂质沉积和大量泡沫细胞及炎性细胞浸润,纤维斑块以M1型巨噬细胞为主,粥样斑块M1与M2表型同时高表达,其中M2型巨噬细胞升高尤为显著,且粥样斑块自噬水平明显高于纤维斑块。纤维斑块组织肿瘤坏死因子α（TNF-α）、单核细胞趋化因子1（MCP-1）、诱导性一氧化氮合成酶（i NOS）、白细胞介素6（IL-6）、白细胞介素12（IL-12）m RNA表达水平均明显高于粥样斑块组织（P〈0.01或0.05）,而精氨酸酶1（Arg-1）、转化生长因子β（TGF-β）、CD163及白细胞介素10（IL-10）表达水平明显低于粥样斑块组织（P〈0.01）。纤维斑块组织p-STAT1及NF-κB表达水平显著升高（P〈0.01）,而粥样斑块组织p-STAT6表达显著升高（P〈0.01）,粥样斑块组织自噬体蛋白LC3-II表达水平明显高于纤维斑块组织（P〈0.01）。研究提示早期动脉粥样硬化斑块中巨噬细胞通过p-STAT1/NF-κB通路诱导向M1型极化,表达适度的自噬水平;而晚期斑块中巨噬细胞则通过激活p-STAT6通路诱导向M2型极化的过渡,M2型巨噬细胞较M1型具有更高的自噬水平。

英文摘要：

This study was designed to investigate the correlation between autophagy and polarization of macrophages in atherosclerosis（AS） plaque in arteriosclerosis obliterans amputees. Femoral artery specimens from arteriosclerosis obliterans amputees were performed hematoxylin and eosin（HE） staining, oil red O and immunofluorescence staining to observe the morphology of atherosclerotic plaque, phenotype of macrophages and autophagy in plaque; using real-time quantitative RT-PCR technology to detect the m RNA level of M1 and M2 type markers in arterial tissue; to analyze polarized signal pathway and autophagy protein levels in macrophages by Western blotting. Arterial specimens staining showed obvious lipid deposition and obvious infiltration of amount of foam cells and inflammatory cells. Macrophages were mainly expression M1 type in percentage in fibrous plaque. Although both M1 and M2 macrophages were upregulated in atheromatous plaque, the increase was dominant in M2 type in percentage. The level of autophagy was significantly higher in the atheromatous plaque than that of fibrous plaque. The expression of tumor necrosis factor-α（TNF-α）, monocyte chemotactic protein-1（MCP-1）, inducible nitric oxide synthase（i NOS）, interleukin-6（IL-6） and interleukin-12（IL-12） m RNA was significantly higher in fibrous plaque than that of atheromatous plaque（P〈0.01 or 0.05）, and arginase-1（Arg-1）, transforming growth factor-β（TGF-β）, CD163 and interleukin-10（IL-10） m RNA was significantly lower than that in atheromatous plaque（P〈0.01）. The levels of p-STAT1 and NF-κB were significantly increased in fibrous plaque（P〈0.01）, while p-STAT6 expression was significantly increased in atheromatous plaque（P〈0.01）. The level of LC3-II was significantly higher in atheromatous plaque than that in fibrous plaque（P〈0.01）. Macrophages in early atherosclerotic plaque were induced to M1 type through p-STAT1/NF-κB pathway and expressed moderate levels of autophagy; while macroph