动脉粥样硬化高、低发区年轻人冠状动脉病变的比较性研究

目的：从流行病病理学的角度，分析和比较动脉粥样硬化（ＡＳ）高发区（北京）、低发区（南宁）及渔区（宁波）年轻人ＡＳ病变检出率及病变特点，并探讨ＡＳ的病变规律，为防治ＡＳ提供依据。方法：收集北京、南宁、宁波等地３０２例意外死亡年轻人（１５～３９岁）新鲜心脏标本的冠状动脉左前降支，苏木素伊红（ＨＥ）、弹力纤维＋ＶａｎＧｉｅｓｏｎ（ＥＴ＋ＶＧ）及苏丹─油红Ｏ染色，经形态学观察将ＡＳ病变分为ＩＶ型。ＡＳ病变检出率比较采用卡方检验。结果：ＡＳ病变检出率随年龄增长而逐渐升高。３０２例左前降支ＡＳ病变总检出率达６８．３％。北京地区ＡＳ病变检出率，尤其是中、晚期病变检出率明显高于南宁及宁波地区并接近受检人群的１／４。北京地区检出斑块的年龄早于南宁及宁波地区，且斑块多显示为动态发展趋势，而南宁、宁波地区斑块多为静止、稳定状态。结论：ＡＳ高、低发区人群冠状动脉粥样硬化病变的发病程度、发展趋势及进展速度均有所不同。我国ＡＳ检出率仍有上升趋势，这一变化应从预防冠状动脉粥样硬化和冠状动脉粥样硬化性心脏病（冠心病）的角度给予高度重视。

Coronary Atheroscl erotic Lesions in Youth From Districts of High and Low Prevalences of Atherosclerosis

Objective: Epidemiologic pathology had been done to compare the prevalences and characteristics of atherosclerotic lesions in youth between Beijing with high prevalence of atherosclerosis (AS) and Nanning,Ningbo (fishing area)with low prevalence of AS and to explore the pathogenesis of AS so as to provide the basis for prevention and treatment of AS.Metheds:Three hundred and two hearts from subjects of accidental death,aged 15-19,were collected in the three districts. HE,ET VG and oil red 0 stain of sections from the left anterior descending bronch (LAD) of coronary artery were performed. Atherosclerotic lesions were divided morphologically into 4 types. The prevalence of AS was statistically analyzed with X2 test.Results:The prevalence of coronary AS (CAS) showed increasing tendency with increasing age. The overall prevalence of AS in the LAD was 68.3%. The prevalence of CAS lesions,expecially the type III and TV lesions,was significantly higher (P<0. 05)in Beijing than those in Nanning and Ningbo samples.Plaques were detected at younger age in Beijing than in Nanning and Ningbo,furthermore plaque,in the Beijing samples were in the developmental state while those in Nanning and Ningbo were relatively static.Conclusion:The degree,developmental trend and speed of CAS are different between districts of high and low prevalences, of AS. The prevalence of CAS still shows increasing tendency in China,indicating that close attention should be paid to the prevention of CAS and coronary heart disease in youth.