Kádár A, Mózes G, Illyés G, Schönfeld T, Kulka J, Sipos B, Glasz T, Tõkés A M, Szik A
2nd Department of Pathology, Semmelweis University of Medicine, Budapest, Hungary.
Nutr Metab Cardiovasc Dis. 1999 Oct;9(5):220-7.
The present work is a chapter in an investigation directed by the World Health Organization on the Pathobiological Determinants of Atherosclerosis In Youth (WHO-PBDAY). Our aim was to study the development of atherosclerotic lesions in a young population.
Samples of left anterior descending coronary artery (LDC) and thoracic (TA) and abdominal aorta (AA) from five Collaborating Centres (Budapest/Hungary, Havana/Cuba, Heidelberg/Germany, Mexico City/Mexico, Peradeniya/Sri Lanka) of 214 subjects who died aged 15 and 34 were analysed at the Budapest Reference Centre. Slides stained with haematoxylin-eosin and with stains for extracellular matrix were quantitatively and qualitatively evaluated. Mean intima/media (I/M) ratio and the prevalence of type III-IV lesions (preatheroma; atheroma; calcified and fibrous atheroma) were determined and compared in different risk factor (high blood pressure, smoking) groups. High I/M ratio was found in the LDC and type III-IV lesions were frequently found both in the LDC and in the AA. I/M ratio and the occurrence of type III-IV lesions increased in all arteries by age. Atherosclerotic lesions in men were more severe, particularly in the LDC. Geographic origin had a limited effect on the histologic lesion parameters. Appearance of type III-IV lesions was associated with substantially different extracellular matrix changes. Myoelastic layer formation was found in each artery in both early and type III-IV lesions. Hypertension was associated with higher prevalence of type III-IV lesions in all arteries, in particular, in the TA; smoking showed a significant effect on the AA only.
Atherosclerotic lesions were found in many of these young subjects. The effect of hypertension and smoking on their development suggests that control of risk factors, beginning in early adolescence, could help to prevent cardiovascular diseases.
本研究是世界卫生组织关于青年动脉粥样硬化病理生物学决定因素（WHO-PBDAY）调查的一个章节。我们的目的是研究年轻人群中动脉粥样硬化病变的发展情况。
来自五个合作中心（匈牙利布达佩斯、古巴哈瓦那、德国海德堡、墨西哥墨西哥城、斯里兰卡佩拉德尼亚）的214名15至34岁死亡者的左前降支冠状动脉（LDC）、胸主动脉（TA）和腹主动脉（AA）样本在布达佩斯参考中心进行分析。对苏木精-伊红染色以及细胞外基质染色的切片进行定量和定性评估。确定并比较不同风险因素（高血压、吸烟）组的平均内膜/中膜（I/M）比值以及III-IV型病变（粥样硬化前期；粥样硬化；钙化和纤维性粥样硬化）的患病率。在LDC中发现高I/M比值，并且在LDC和AA中均频繁发现III-IV型病变。所有动脉的I/M比值和III-IV型病变的发生率随年龄增加。男性的动脉粥样硬化病变更严重，尤其是在LDC。地理来源对组织学病变参数的影响有限。III-IV型病变的出现与细胞外基质的显著不同变化相关。在早期病变和III-IV型病变的每条动脉中均发现了肌弹性层形成。高血压与所有动脉中III-IV型病变的较高患病率相关，尤其是在TA中；吸烟仅对AA有显著影响。
在许多这些年轻受试者中发现了动脉粥样硬化病变。高血压和吸烟对其发展的影响表明，从青春期早期开始控制风险因素可能有助于预防心血管疾病。
