Fernández-Britto J E, Bacallao J, Castillo J A, Campos R, Wong R, Guski H
Department of Pathology, Faculty of Medicine Finlay-Albarran, Hospital Dr. C. J. Finlay, Havana, Cuba.
Zentralbl Pathol. 1991;137(6):487-91.
The three major epicardial coronary arteries of a set of 472 autopsy cases divided into four groups: a) non-diabetics and non-hypertensive, 322 subjects; b) hypertensive, 75 subjects; c) diabetics, 57 subjects and d) hypertensive and diabetic, 17 subjects, were studied. Classical pathomorphological procedures and an atherometric system (AS), suitable to characterize the atherosclerotic lesions, was used searching for differences between the level of atherosclerosis into these four groups and its eventual progression according to the time of evolution of these diseases. Raw data processing was full automated and some univariate and multivariate statistical procedures (means, standard deviations, ANOVA, MANOVA and principal components analysis) were performed using two commercial statistical packages: "NCSS" and "SYSTAT". The most remarkable findings were the following: Diabetes and hypertension have both strong impact upon the rate at which the atherosclerotic process takes place in subjects affected by these diseases. The time of evolution of both diseases correlates positively and independently of age with the velocity of the atherosclerotic process at the three coronary arteries. The impact of diabetes seems to be stronger and is particularly expressed by the severe plaques (Z) while the effect of hypertension is specially observable at the fibrous plaques (Y). There seems to be no significant interaction (synergism) between the two risk factors upon the measurement of the atherosclerotic lesions, that is, they have an additive effect. Two simple underlying factors can be used to account for interindividual differences. These two factors are "dominated", respectively, by fibrous (Y) and severe plaques (Z).
对472例尸检病例的三支主要心外膜冠状动脉进行了研究，这些病例分为四组：a）非糖尿病且非高血压患者，322例；b）高血压患者，75例；c）糖尿病患者，57例；d）高血压合并糖尿病患者，17例。采用经典病理形态学方法和一种适合于表征动脉粥样硬化病变的动脉粥样硬化测量系统（AS），以寻找这四组之间动脉粥样硬化程度的差异及其根据这些疾病的病程的最终进展情况。原始数据处理是完全自动化的，并且使用两个商业统计软件包“NCSS”和“SYSTAT”进行了一些单变量和多变量统计程序（均值、标准差、方差分析、多变量方差分析和主成分分析）。最显著的发现如下：糖尿病和高血压对受这些疾病影响的受试者动脉粥样硬化进程发生的速率都有强烈影响。这两种疾病的病程与三条冠状动脉处动脉粥样硬化进程的速度呈正相关且与年龄无关。糖尿病的影响似乎更强，尤其表现为严重斑块（Z），而高血压的影响在纤维斑块（Y）处特别明显。在测量动脉粥样硬化病变时，这两种危险因素之间似乎没有显著的相互作用（协同作用），即它们具有相加作用。可以用两个简单的潜在因素来解释个体差异。这两个因素分别由纤维斑块（Y）和严重斑块（Z）“主导”。
