von Maravic C, Kessler C, von Maravic M, Hohlbach G, Kömpf D
Department of Neurology, University of Medicine, Lübeck, Germany.
Eur J Surg. 1991 Mar;157(3):185-8.
In this study the correlation between hemispherical ischemic symptoms and the presence of intraplaque hemorrhage in carotid plaques has been evaluated. 38 patients who had undergone carotid endarterectomy were examined clinically and the specimens obtained from operation were studied morphologically. The patients were divided into two groups, asymptomatic and symptomatic regarding the territory of the supplying carotid artery. The presence of intraplaque hemorrhage, shown by Ladewig's Trichrom stain, as well as evidence of iron, immunohistochemical stain of hemoglobin and native fluorescence microscopy was noted, and, according to their extension, classified into three degrees. As a result, there was neither a correlation between history of ischemic brain symptoms and the presence of intraplaque hemorrhage, nor between clinical symptoms and extension of hemorrhage. The plaques were high degree stenotic (greater than 80%) in most of the patients and showed various degenerative changes. In 97% of all plaques with hemorrhages surface defects were seen. Our results confirm that intraplaque hemorrhage is one out of a series of pathological events which occurs during advanced atherosclerosis. Blood inflow from the lumen through an already damaged plaque surface is a common event and a correlation with the onset of symptoms is unlikely.
在本研究中，已对半球缺血症状与颈动脉斑块内斑块内出血的存在之间的相关性进行了评估。对38例行颈动脉内膜切除术的患者进行了临床检查，并对手术获取的标本进行了形态学研究。根据供应颈动脉区域的情况，将患者分为无症状组和有症状组。通过Ladewig三色染色显示斑块内出血的存在，以及铁的证据、血红蛋白免疫组化染色和天然荧光显微镜检查，并根据其范围分为三个程度。结果，缺血性脑症状史与斑块内出血的存在之间、临床症状与出血范围之间均无相关性。大多数患者的斑块为高度狭窄（大于80%），并表现出各种退行性改变。在所有有出血的斑块中，97%可见表面缺损。我们的结果证实，斑块内出血是晚期动脉粥样硬化过程中发生的一系列病理事件之一。血液从管腔通过已经受损的斑块表面流入是常见现象，与症状发作不太可能存在相关性。
