中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
2期
119-122
,共4页
王菁%李曦铭%徐美林%丛洪良
王菁%李晞銘%徐美林%叢洪良
왕정%리희명%서미림%총홍량
尸体解剖%冠状动脉硬化%病理学%急性冠状动脉综合征
尸體解剖%冠狀動脈硬化%病理學%急性冠狀動脈綜閤徵
시체해부%관상동맥경화%병이학%급성관상동맥종합정
Autopsy%Coronary arteriosclerosis%Pathology%Acute coronary syndrome
目的 观察不同年龄患者的冠状动脉粥样硬化特征,分析其危险因素及病变特点.方法 回顾性分析天津市胸科医院1986年2月至201 1年12月87例尸检证实的冠状动脉粥样硬化患者的临床病理资料,按20 ～＜ 40、40 ～＜ 60和≥60岁3个年龄段对冠状动脉狭窄程度和急性冠状动脉综合征的心脏病理学改变、易损斑块发生情况及形态学特点进行比较分析.结果 87例患者中,男56例,女31例；年龄23 ～ 80岁,平均66.8岁,其中20 ～＜ 40岁12例,40 ～＜ 60岁24例,≥60岁51例.冠状动脉狭窄等级在不同性别的差异有统计学意义(P＜0.05),在以上3个年龄段间的差异均无统计学意义(均P＞0.05).急性冠状动脉综合征患者以上3个年龄段中大脂核所占比例分别为23.5％、38.5％、53.8％(x2=6.282,P=0.043),薄纤维帽所占比例分别为29.4％、41.0％ 、58.8％(x2=6.589,P=0.037),炎细胞浸润所占比例分别为58.8％、69.2％、85.0％(x2=7.435,P=0.024),钙化形成所占比例分别为35.3％、56.4％、71.3％(x2 =8.599,P=0.014).以上3个年龄段患者易损斑块检出率分别为76.5％、84.6％、88.8％(x2=1.850,P=0.397).结论 不同性别和年龄的患者冠状动脉病变特征和危险因素不同,提示应重视对年轻患者及冠脉轻度狭窄伴易损斑块患者的早期诊断和合理治疗.
目的 觀察不同年齡患者的冠狀動脈粥樣硬化特徵,分析其危險因素及病變特點.方法 迴顧性分析天津市胸科醫院1986年2月至201 1年12月87例尸檢證實的冠狀動脈粥樣硬化患者的臨床病理資料,按20 ～＜ 40、40 ～＜ 60和≥60歲3箇年齡段對冠狀動脈狹窄程度和急性冠狀動脈綜閤徵的心髒病理學改變、易損斑塊髮生情況及形態學特點進行比較分析.結果 87例患者中,男56例,女31例；年齡23 ～ 80歲,平均66.8歲,其中20 ～＜ 40歲12例,40 ～＜ 60歲24例,≥60歲51例.冠狀動脈狹窄等級在不同性彆的差異有統計學意義(P＜0.05),在以上3箇年齡段間的差異均無統計學意義(均P＞0.05).急性冠狀動脈綜閤徵患者以上3箇年齡段中大脂覈所佔比例分彆為23.5％、38.5％、53.8％(x2=6.282,P=0.043),薄纖維帽所佔比例分彆為29.4％、41.0％ 、58.8％(x2=6.589,P=0.037),炎細胞浸潤所佔比例分彆為58.8％、69.2％、85.0％(x2=7.435,P=0.024),鈣化形成所佔比例分彆為35.3％、56.4％、71.3％(x2 =8.599,P=0.014).以上3箇年齡段患者易損斑塊檢齣率分彆為76.5％、84.6％、88.8％(x2=1.850,P=0.397).結論 不同性彆和年齡的患者冠狀動脈病變特徵和危險因素不同,提示應重視對年輕患者及冠脈輕度狹窄伴易損斑塊患者的早期診斷和閤理治療.
목적 관찰불동년령환자적관상동맥죽양경화특정,분석기위험인소급병변특점.방법 회고성분석천진시흉과의원1986년2월지201 1년12월87례시검증실적관상동맥죽양경화환자적림상병리자료,안20 ～＜ 40、40 ～＜ 60화≥60세3개년령단대관상동맥협착정도화급성관상동맥종합정적심장병이학개변、역손반괴발생정황급형태학특점진행비교분석.결과 87례환자중,남56례,녀31례；년령23 ～ 80세,평균66.8세,기중20 ～＜ 40세12례,40 ～＜ 60세24례,≥60세51례.관상동맥협착등급재불동성별적차이유통계학의의(P＜0.05),재이상3개년령단간적차이균무통계학의의(균P＞0.05).급성관상동맥종합정환자이상3개년령단중대지핵소점비례분별위23.5％、38.5％、53.8％(x2=6.282,P=0.043),박섬유모소점비례분별위29.4％、41.0％ 、58.8％(x2=6.589,P=0.037),염세포침윤소점비례분별위58.8％、69.2％、85.0％(x2=7.435,P=0.024),개화형성소점비례분별위35.3％、56.4％、71.3％(x2 =8.599,P=0.014).이상3개년령단환자역손반괴검출솔분별위76.5％、84.6％、88.8％(x2=1.850,P=0.397).결론 불동성별화년령적환자관상동맥병변특정화위험인소불동,제시응중시대년경환자급관맥경도협착반역손반괴환자적조기진단화합리치료.
Objective To explore the features of coronary atherosclerosis among the patients at different ages and examine their risk factors and pathological characteristics.Methods Retrospective analysis was performed for the clinicopathologic data of 87 patients with coronary atherosclerosis confirmed through autopsy from February 1986 to December 2011 at our hospital.They were divided into 3 groups according to age (20-＜40 years,n =12; 40-＜60 years,n =24; ＞60 years,n =51).Comparative analysis was performed for the degree of coronary artery stenosis and cardiac pathological changes,vulnerable plaque occurrence and morphological features of acute coronary syndrome among different patient groups.Results There were 56 males and 31 females with a mean age of 66.8 years (range:23-80).Great statistical differences existed in the degree of coronary artery stenosis between different genders (P ＜0.05) while there was no significant difference among the above age groups (P ＞ 0.05).In the above age groups of patients with acute coronary syndrome,the incidence of big lipid core was 23.5％,38.5％ and 53.8％ (x2 =6.282,P =0.043),that of thin fibrous cap 29.4％,41.0％ and 58.8％ (x2 =6.589,P =0.037),that of inflammatory cell in 2 filtration 58.8％,69.2％ and 85.0％ (x2 =7.435,P =0.024) and that of calcification formation 35.3％,56.4％ and 71.3％ respectively (x2 =8.599,P =0.014).And the incidence of vulnerable plaque occurrence was 76.5％,84.6％ and 88.8％ (x2 =1.850,P =0.397) in the above age groups.Conclusions The features and risk factors of coronary atherosclerosis are different according to different ages and genders.Thus we should pay more attention to the early diagnosis and reasonable treatments of young patients and those with both mild coronary stenosis and vulnerable plaque.
