MORPHOMETRIC ANALYSIS OF THE COMPOSITION OF ATHEROSCLEROTIC PLAQUES

我们在尸检时研究了4个主要动脉粥样硬化斑块的组成， （右、左主干、左前降支和左回旋支）心外膜 15例死于急性心肌梗死的患者的冠状动脉 心肌梗死（AMI）和12例冠心病猝死患者 (SCD)没有AMI。冠状动脉心外膜动脉的切片厚度为5 mm 间隔，并将每段动脉的Movat染色切片， 制备并使用计算机化形态测定系统分析。内 AMI组和SCD组内， 4个主要心外膜冠状动脉中的任何一个之间的组成。内 两组菌斑形态均随横截面积而变化 段的缩小。在这两组中， 无细胞纤维组织、钙化组织和粉屑增多 以线性方式随着横截面积的增加 节段变窄和细胞纤维组织的量 直线下降。在AMI组中， 牙髓碎屑和细胞纤维组织明显分离 狭窄（>75%横截面积）节段与较不狭窄（<75%）节段 片段AMI组与SCD组比较， 差异牙菌斑中由牙垢碎屑组成的百分比（16%， 心肌梗死组和SCD组分别为7%和11% -vs- 18%）和重度钙化组织（8% -vs- 16%）的显著性差异（P <0.05）。 AMI组与SCD组在严重狭窄节段中存在差异。 15例AMI患者中13例有闭塞性冠状动脉血栓，1例无闭塞性冠状动脉血栓。 在12个SCD病例中。因此，冠状动脉血栓和斑块的频率 在AMI患者和无AMI的SCD患者中，

We studied at necropsy atherosclerotic plaque composition in the 4 major (right, left main, left anterior descending and left circumflex) epicardial coronary arteries in 15 patients who died of consequences of an acute myocardial infarction (AMI) and in 12 patients with sudden coronary death (SCD) without AMI. The coronary epicardial arteries were sectioned at 5-mm intervals, and a Movat stained section of each segment of artery was prepared and analyzed using a computerized morphometry system. Within the AMI group and within the SCD group, there were no differences in plaque composition among any of the 4 major epicardial coronary arteries. Within both groups plaque morphology varied as a function of cross-sectional-area narrowing of the segments. In both groups, the amount of dense relatively acellular fibrous tissue, calcified tissue, and pultaceous debris increased in a linear fashion with increasing degrees of cross-sectional-area narrowing of the segments and the amount of cellular fibrous tissue decreased linearly. In the AMI group, the percent of plaque consisting of pultaceous debris and of cellular fibrous tissue separated significantly narrowed (>75% cross sectional area) segments from less narrowed (<75%) segments. A comparison of the AMI group to the SCD group showed significant differences. The percent of plaque consisting of pultaceous debris (16% in the AMI group and 7% in the SCD group), of cellular fibrous tissue (11% -vs- 18%) and of heavily calcified tissue (8% -vs- 16%) were significantly different in the severely narrowed segments in the AMI and SCD groups. Occlusive coronary thrombi were present in 13 of the 15 AMI cases and in 1 of the 12 SCD cases. Thus, the frequency of coronary thrombi and plaque composition differ in patients with AMI and in those with SCD without AMI.