人窦房结动脉图像定量分析

Quantitative image analysis of the human sinus node artery

目的：探讨描述窦房结动脉的客观血管指标,建立青壮年窦房结动脉的正常参考值范围及狭窄标准,为进一步研究青壮年窦房结动脉狭窄程度与猝死的关系奠定基础.方法：采集符合纳入标准的74例非心源性死亡者心窦房结组织,进行H-E染色、弹力及胶原纤维双色染色,应用图像分析技术检测窦房结动脉内径周长、内外径周长比值.结果：窦房结动脉内腔周长263.83～1 912.20 μm,平均（896.78±357.17） μm,男女比较差异有统计学意义,不同身高及不同年龄组比较差异均无统计学意义;窦房结动脉内外腔周长比43.34％～70.74％,平均57.97％±5.51％,男女比较及不同身高组比较差异无统计学意义,但不同年龄组的比值差异有统计学意义,其中,年龄层组间比较仅50岁以上年龄组和10～19、20～29、30～39年龄组窦房结动脉内外腔周长比值差异具有统计学意义,其余各年龄组之间相互比较差异无统计学意义.结论：对40岁以下青壮年而言,窦房结动脉内腔及外腔周长比值不受性别、年龄、身高等因素的影响,是评价青壮年窦房结动脉有无狭窄的良好指标,建议窦房结动脉内外周长比值≥50％者可视为血管管壁无增厚,管腔无狭窄.

Objective：To determine the size of sinus node artery （SNA）,and to explore the normal reference range of the sinus node artery and the standard for the stenosis of sinus node artery.Methods：A total of 74 patients who died of noncardiac disease were included in accordance with the inclusion criteria.The all sinus node of specimens was studied by paraffinembedded serial sections and HE staining,Masson＇s staining and Double staining.The lumen perimeter and outer diameter of the sinus node artery were assessed by image analysis system.The ratio of lumen perimeter to outer perimeter were calculated and the gender,age,height of the deceased patients were noted.All statistical analyses were adopted by SPSS 11.5 software packet that include statistic description and ANOVA.Results：The lumen perimeter of the sinus node artery were 263.83～ 1 912.20μm （mean 896.78 ± 357.17 μm）.There had no statistical difference in different age groups and height groups.But the female＇s lumen perimeter of the sinus node artery was smaller than man＇s.The ratios of lumen perimeter to outer perimeter of sinus node artery were 43.34％-70.74％ （mean 57.97％ ± 5.51％）.There had no statistical difference in different gender groups and height groups.The ratio of lumen perimeter to outer perimeter of the sinus node artery in the group of 50 years old and older was smaller than that of other age groups.In particular,it was significantly smaller than 10-19,20-29 and 30-39 years old groups.But there had no statistical difference in 10-19,20-29 and 30-39 years old groups.Conclusion：Under 40 years old,there has no relationship between gender/age/height and the ratio of lumen perimeter to outer perimeter of sinus node artery.The latter should be a good indicator of the sinus node artery under 40 years old.And we recommend that the normal range of the ratio is ≥50 ％.