THE GEOGRAPHIC PATHOLOGY OF ATHEROSCLEROSIS *
THE GEOGRAPHIC PATHOLOGY OF ATHEROSCLEROSIS *
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动脉粥样硬化的地理病理学 *
DOI：
10.1111/j.1749-6632.1968.tb53846.x
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发表时间：
1968
影响因子：
5.2
通讯作者：
J. Strong
中科院分区：
文献类型：
--
作者：
H. Mcgill;J. Strong
许多研究者已经描述了不同人群尸检中动脉粥样硬化的严重程度。有些人比较了几个人群中尸检者的动脉粥样硬化。然而，分级方法多种多样，数量通常很少，并且一次只比较了少数地理和种族不同的人群。1959年，来自几个国家的病理学家组织了一次合作调查，以获得不同人群动脉粥样硬化的可靠和可比数据。表1显示了参与调查的病理学家nho的姓名和地点以及他们收集动脉的种族群体。这些病理学家于1960年在危地马拉会见了中美洲和巴拿马营养研究所，起草了一份研究方法的标准操作规程，并在1960年至1965年期间共收集了23，000例病例。在每个实验室，技术人员解剖了在法医服务机构或大型综合医院解剖的10至69岁的人的冠状动脉和动脉。然后，病理学家将这些动脉沿着辅助信息提交给中心实验室。在中央演讲厅。我们用苏丹红四号染了动脉然后重新包装在塑料袋里。一个由五名病理学家组成的小组估计了每一条动脉内表面脂肪条纹、纤维斑块、复杂病变和钙化病变的百分比。监督统计员介绍了标准化分级和估计方法误差的程序。你知道尸检材料作为关于活着的人口的信息来源的局限性。我们不能详细讨论这些限制。但会展示我们如何试图减少由于不同死因而产生的偏差。首先，我们排除了所有已知与更严重的动脉粥样硬化相关的疾病的病例，例如冠心病、中风、高血压。和糖尿病我们将死亡原因分为四大类：意外事故、癌症、感染和选定的其他原因。然后，我们比较了这四组中每种类型的动脉粥样硬化病变在每个位置，种族，性别和年龄亚组。没有出现一致的差异。因此，我们将这四个类别合并为一个大组，
Many investigators have described the severity of atherosclerosis in autopsied persons from various populations. Some have compared atherosclerosis among autopsied persons from several populations. However, grading iiiethods have varied, numbers have often been small, and only a few geographically and ethnically different populations have been compared at one time. In 1959, pathologists from several countries organized a cooperative suryey to secure reliable and comparable data on atherosclerosis from different populations. TABLE 1 shows the names and locations of the pathologists nho participated in the survey and the ethnic groups from which they collected arteries. These pathologists met a t the Institute of Nutrition of Central America and Panama in Guatemala in 1960, drafted a standard operating protocol of methods for the study, and collected a total of 23,000 cases betiveen 1960 and 1965, The methods were simple. In each laboratory, technicians dissected the coronary arteries and aortas from persons ten to 69 years old autopsied in iiietlicolegal services or large general hospitals. The pathologist then submitted these arteries, along with accessory information, to a central laboratory. In the central lalioratory. we stained the arteries with Sudan IV and repackaged them i n plastic bags. A% team of five pathologists estimated for each artery the percent intinial surface involved by fatty streaks, fibrous plaques, complicated lesions, and calcified lesions. The supervising statistician introduced procedures to stantlardize the grading and to estimate the error of the method. \Ye are aware of the limitations of autopsy material as a source of information about the living population. W e cannot discuss these limitations in detail. but will show how we attempted to reduce bias due to different causes of death. First, we excluded all cases with diseases known to be associated with more severe atherosclerosis, such as coronary heart disease, stroke, hypertension. and diabetes. W e formed four broad cause-of-death categoriesaccidents, cancers, infections, and selected miscellaneous causes. W e then compared each type of atherosclerotic lesion among these four groups within each location, race, sex, and age subgroup. No consistent differences appeared. Therefore, we pooled the four categories into one large group and