老年患者股动脉粥样硬化的病理学特点与冠状动脉和颈动脉粥样硬化的比较

目的　探讨老年患者股动脉粥样硬化的病理学特点 ,并与同一个体的冠状动脉、颈动脉粥样硬化进行比较。方法　收集我院老年尸体解剖病例 15例。将所有病例之两侧股动脉、颈动脉及左冠状动脉前降支进行连续取材 ,光镜下观察三者动脉粥样硬化病变的形态学、病变分布情况 ,并对动脉粥样硬化程度进行评分。结果　在老年患者中 ,股动脉粥样硬化病变以晚期斑块尤其是复合病变为主 ,与颈动脉、冠状动脉粥样硬化相似。右股动脉的斑块检出率达 93.3%。与左冠状动脉前降支比较 ,股动脉和颈动脉粥样硬化的范围较小 ,程度较轻。三者在动脉粥样硬化程度和范围上无相关性。结论　股动脉和颈动脉粥样硬化可作为研究冠状动脉粥样硬化发生的间接指标。但在同一个体 ,不能用股动脉、颈动脉粥样硬化评估冠状动脉动脉粥样硬化的程度和范围。

The pathological characteristics of femoral atherosclerosis in the elderly patients and comparison with carotid and coronary atherosclerosis

Objective To observe the pathological characteristics of femoral atherosclerosis in the elderly patients, and compare with carotid and coronary atherosclerosis in a same person.Methods Fifteen autopsy cases were selected.Serial sections of femoral, carotid and left anterior descending branch of coronary artery of all cases were performed.The morphology and distribution of atherosclerotic lesions were observed microscopically, and the degree and range of atherosclerosis in all arteries were evaluated.Results In the elderly patients, most of the atherosclerotic lesions were advanced plaques, especially the complex lesions in femoral atherosclerosis,which were similar to those in carotid and coronary atherosclerosis. Incidence of plaques was 93.3% in right femoral artery. Compared with left anterior descending branch of coronary artery,the atherosclerotic lesions were not so wide and serious in femoral and carotid arteries. The correlation was absent between the three kinds of arteries either in the degree or range of atherosclerotic lesions.Conclusions Atherosclerosis in the lower limbs should be emphasized in the elderly patients. The femoral and carotid atherosclerosis may reflect coronary atherosclerosis indirectly, but in a same person, femoral and carotid atherosclerosis can not be used to evaluate the degree and range of coronary atherosclerosis.