Characteristics of coronary microvascular lesions in autopsied elderly with hypertensive left ventricular hypertrophy  

老年高血压左心室肥厚患者冠状循环微血管病理改变特点(英文)

作　　者：李小鹰[1] 李蕊[1] 于雯[1] 石怀银[1] 韦力新[1] 

机构地区：[1]解放军总医院老年心内科,北京100853

出　　处：《Chinese Medical Journal》2002年第5期658-663,146-147,共6页中华医学杂志（英文版）

摘　　要：OBJECTIVE: To observe the characteristics of coronary microvascular lesions (CML) in the autopsied elderly cases with hypertensive left ventricular hypertrophy (LVH) and the difference of CML among the groups of essential hypertension (EHT), coronary heart disease (CHD) and diabetes (NIDDM) also with LVH. METHODS: A retrospective study was performed in 206 cases > or = 60 years old of EHT, CHD and NIDDM with LVH and 30 normal cases as control, out of 3195 consecutive autopsied cases from 1954 to 1996 in our hospital. Arterioles with diameters of 10 - 60 microm and capillaries in the muscular layer were shown by the methods of HE, Elastic fiber + VG staining and immunohistochemistry of CD31. Quantitative measurements on the arteriole density (AD), the ratio of arteriolar wall and cavity (RWC), capillary density (CD) and the area of endothelial cell (AEC) were performed with light microscope observation and image analysis by computer. According to the thickness of the left ventricle free wall, the severity of LVH was divided into four degrees from 0 to III. LVH of degree 0-III was observed in EHT group, while only LVH of degree I was found in CHD, EHT + CHD, and NIDDM groups. SAS system was used for statistical analysis. RESULTS: AD and RWC increased while CD and AEC decreased significantly with the progression of LVH in EHT groups (P了解老年高血压左心室肥厚 (LVH)患者冠状循环微血管病变的特点 ,并在LVH分级相同的条件下 ,观察高血压、冠心病、糖尿病心肌微血管病变的区别。方法　从我院 195 4～ 1996年间 3195例连续尸检标本中选取年龄≥ 6 0岁的高血压病、冠心病、高血压合并冠心病、糖尿病 2 0 6例和对照组 30例共 2 36例心脏标本进行HE、弹力 +VG和CD31免疫组化染色 ,显示心肌间质 10- 6 0微米动脉和心肌毛细血管 ,通过光镜和电脑图象分析 ,定量检测微动脉密度及其壁腔比值、心肌毛细血管密度及其内皮细胞面积四项指标 ;根据左室游离壁厚度将LVH分为 0级 -Ⅲ级 ;高血压组LVH 0 -Ⅲ级 ,冠心病组、高血压合并冠心病组、糖尿病组LVH均为Ⅰ级。各组间比较采用SAS系统处理。结果　各组冠状循环微血管定量测定结果显示 :高血压组随LVH加重 ,微动脉密度和壁腔比值逐渐增大 ,而毛细血管密度与内皮细胞面积逐渐减小 (P <0 .0 5 - 0 .0 1) ;高血压合并冠心病LVH组有类似改变但程度更重 (P <0 .0 1) ;冠心病LVH组微动脉密度增加 (P <0 .0 5 )而其他指标变化不明显 ;糖尿病组壁腔比值无明显改变 ,而微动脉密度增高 ,毛细血管密度及内皮细胞面积明显减少 (P均 <0 .0 5 )。结论　高血压LVH时冠状循环微血管段的改变表现为微动脉密度增高 ,壁?

关 键 词：Aged AUTOPSY Coronary Circulation Coronary Disease Coronary Vessels Diabetes Mellitus  Type 2 Female Humans Hypertension Hypertrophy  Left Ventricular Male Middle Aged 

分 类 号：R541.3[医药卫生—心血管疾病]