年轻人冠状动脉内膜增厚的形态定量研究
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国家“八、五”攻关课题


Morphometric Study on Intimal Thickening of Coronary Arteries in Youth
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    摘要:

    为研究冠状动脉内膜增厚的年龄性改变及其与动脉粥样硬化发生发展的关系。应用Quamtiment970图像分析仪对北京地区102例意外死亡年轻人(15~39岁)冠状动脉近侧端进行了形态定量及统计学处理。结果是,内膜增厚随年龄增长而增加,男厚于女,在同体三支冠脉的比较研究中内膜增厚的速度与程度均以左前降支居首位,依次为右冠状动脉和左旋支。两性20~24岁内膜增厚速度及平均年递增率较快,25~34岁的十年间渐趋平稳,男性35~39岁及女性30~34岁再次出现增厚高峰.前者管腔狭窄率达57.4%。内膜增厚的形态呈弥漫性和偏心性。本研究提示内膜增厚的年龄性改变是从生理性向病理性发展的过程,是动脉粥样硬化形成的组织学基础,也为动脉粥样硬化和冠心病的预防及诊断提供了重要的形态学依据.

    Abstract:

    To investigate the relationship between the quantitative morphometric characteristics of intimal thickening and coronary atherosclerosis, 306 coronary arteries from 102 autopsied cases, 61 males and 41 females.aged 15 to 39 years (divided into 5 age groups), in Beijing were morphometrically studied.Methods By using an image analysis system, intimal and medial thickness was measured,intimal to medial thickness ratio, eccentricity index, luminal stenosis rate. and average annual increasing rate in intimal thickness were calculated.Results The intimal thickness increased with ageing.The intima was markedly thicker in males than in females of the same age group. Among the 3 coronary arteries[left anterior descending (LAD),right coronary (RC) .and left circumalex(LC) ]studied, the rate and degree of intimal thickening were most marked in the LAD and then the RC and LC. Intimal thickening increased more rapidly in the LAD in both sexes in the 20 ~24 years group with average annual increasing rates of 8. 6 % (males) and 9. 5% (females). The thickness then remained steady. However, a second peak of thickening of the LAD in the 35~39 years group in males with a average annual increasing rate of 9. 2% ,meanwhile the percentage of luminal stenosis was 57.4%. The average annual increasing rate of LAD was up to 3. 8% in females in the 30 to 34 y6ars group with no further increase in the 35~39 years group,but the percentage of luminal stenosis was <51 %. Two different types of thickening,namely diffused and eccentric,were found, the latter with characteristic features of atherosclerosis is prone to develop into atherosclerosis plague. The type of thickening of LAD which shows the highest prevalence of CHD clinically was eccentric.Conclusions Intimal thickening with ageing is a changing from physiological to pathological process and intimal thickening froms the structural base for atherosclerosis.

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赵红,赵培真,韩晓男,梁凤玲,杨方,杨瑞彪,武阳丰,张振声,唐金河.年轻人冠状动脉内膜增厚的形态定量研究[J].中国动脉硬化杂志,1995,3(1):18~23.

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  • 收稿日期:1994-11-20
  • 最后修改日期:1995-01-28
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