冠心病猝死冠脉斑块组成成分的病理形态学改变

目的探讨冠心病猝死(SCD)组和对照组冠脉粥样硬化斑块纤维帽厚度和脂质核心百分比的差异。方法随机挑选病例及心脏标本共64例,分为SCD组和对照组。在冠脉粥样硬化最严重的部位取材,制片,并行HE染色,显微镜观察冠脉的病理变化和斑块的组成,采用图像分析系统对冠脉斑块纤维帽厚度和脂质核心与整个斑块的百分比进行定量分析,所得数据用SPSS11.5统计软件进行数据分析。结果SCD组中,冠脉粥样硬化病变Ⅳ级21例,Ⅲ级15例,对照组中冠脉粥样硬化病变Ⅳ级12例,Ⅲ级16例,两组在病变的严重程度上未见显著性差异(P>0.05);两组冠脉粥样硬化斑块纤维帽的厚度和脂质核心百分比均有显著性差异(P<0.01)。结论SCD组与对照组在冠脉粥样斑块的纤维帽厚度和脂质核心百分比大小等两方面均存在显著性差异;对SCD的病理诊断和法医学鉴定都具有重要意义。

Pathomorphologic study of the fibrous cap and fatty core of coronary arthrosclerotic plaque in sudden coronary death

Objective The differences in the thickness of fibrous cap and the percentage of fatty core of the coronary atherosclerotic plaques between sudden coronary death(SCD) group and the control group were investigated.Methods Sixty-four autopsy cases were divided into SCD and control groups.Samples were taken from the most severely damaged portions of the coronary atherosclerotic plaques,sectioned,stained with HE,and examined by light microscopy for morphologic changes and structural alternations.Image analysis system was adopted to compare the thickness of fibrous cap and percentage of fatty core in the whole plaque between the two groups,and all data were analyzed and calculated with SPSS 11.5 statistic software.Results There were 15 grade III and 21 grade IV atherosclerotic cases found in the SCD group,while there were 16 and 12 found in the control group,respectively.Although no significant differences on the severity of atherosclerosis were found between the two groups(P>0.05),there were significant differences on the thickness of the fibrous cap and the percentage of fatty core found between the two groups(P<0.01).Conclusion Our study indicates that there are significant differences in the thickness of fibrous cap and the percentage of fatty core in atherosclerosis plaques between the SCD group and the control group.These observed differences may be helpful for morphological diagnosis of SCD.