动脉粥样硬化高、低发区冠状动脉血管壁定量形态学对比性研究

Comparative morphometric study of coronary artery walls collected from high and low prevalence areas of atherosclerosis in China

为研究平滑肌细胞（SMC）在冠状动脉血管壁中的增殖消长、与动脉粥样硬化（AS）的关系以及在AS高低发区的差异,应用Quantimet970图像分析仪及其Quips软件测试268例AS高（北京109）低（宁波64、南宁95）发区15～39岁意外死亡者的冠状动脉左前降支血管管壁细胞核数密度及面密度,应用特殊染色方法及偏振光显微镜观察胶原纤维的变化。结果为:三地区男性内膜细胞核数密度之间无明显差异,但均有随年龄增加而逐渐降低的趋势,并以北京为明显,女性年龄性变化趋势均不明显;男性绝大多数年龄组的内膜细胞核面密度北京均低于宁波及南宁,男性及北京女性均有年龄性变化趋势;三地区男性中膜细胞核数密度均有年龄性变化的趋势,女性则无;三地区男性或女性中膜细胞核面密度的年龄性变化趋势均不明显,但大多数年龄组北京均低于宁波及南宁。随着年龄增加左前降支血管壁内膜Ⅰ、Ⅲ型胶原纤维均逐渐增多,高发区较低发区明显。AS病变中Ⅰ、Ⅲ型胶原纤维均有不同程度的增多。结果提示AS高发区人群左前降支血管壁年龄性老化趋势较低发区明显,此可能是AS发生发展较快的局部因素。

The left anterior descending branches of coronary artery were collected from 268 autopsies of patients (15-39 years of age) after sudden death such as traffic accidents or violence in atherosclerosis (AS) high (Beijing. 109 cases) and low (Ningbo, 64 cases and Nanning, 95 cases) prevalence areas. In order to investigate the relationship between the age and the atherosclerotic lesions, numerical density and area density of smooth muscle cells (SMC) of the intima and media were measured by image analysis, and the collagen types Ⅰ and Ⅲ were stained with picrosirus red and examined under a polarizing microscope. The results showed that there was no significant difference in numerical densities of intimal SMC among the 3 areas, but there was a decreasing tendency with aging among males in these areas, especially in Beijing. No such a tendency was seen among females. In most age groups, the area density of intimal SMC from both males and females in Beijing was lower than those of Ningbo and Nanning groups, and a-mong most groups in all areas there was a decreasing tendency with the increase of age. The numerical density of media SMC in males in the 3 areas showed a decreasing tendency with the in-crease of age, but not in the females, and there was no significant difference between male and female groups in each area. The area density of media SMC of males or females did not show a great variation with aging, but the values in groups from Beijing area were lower than those from Ningbo and Nanning areas. There was an increasing tendency of the amount of collagen type Ⅰ and Ⅲ with aging, and it was more obvious in AS high prevalence area. There was also an increase of collagen with the development of AS lesions. The findings indicate that there is a more prominent tendency of aging-related acceleration of the left descending branch of coronary artery among subjects from the AS high prevalence area, and it may constitute a local factor affecting the susceptibillty to atherosclerosis.