Department of Anatomy, College of Medicine, University of Ibadan, P O Box 14259, Ibadan, Nigeria.
BMC Cardiovasc Disord. 2012 Nov 16;12:106. doi: 10.1186/1471-2261-12-106.
There has been a paucity of autopsy studies on atherosclerotic lesions in Nigerians, the last one conducted at our centre being more than four decades ago. There has also been considerable epidemiological transition. The objective of the study was to determine the frequency, severity, pattern and distribution of atherosclerotic lesions in extra cranial carotid arteries (ECCA) in Nigerians at autopsy.
ECCA of 30 consecutive Nigerian patients undergoing autopsy at a University teaching hospital were examined using the American Heart Association (AHA) histological grading and classification of atherosclerosis.
Atherosclerotic lesions of ECCA were present in 73.3% of the subjects with the right and the left carotid bifurcations (28.3%) being the most frequently affected sites. Using the AHA classification of atherosclerosis, a total of 176(73.3%) lesions were found in the 240 histological sections of blood vessels examined. Of these, 22.5% were types I, 22.5% were types II, 15.4% were type V, and 7.5% were type III. The VII to type IX lesions were rare. When these atherosclerotic lesions were grouped into mild, moderate and severe, 52.5% were mild lesions (types I-III); 18.3% were moderate lesions (types IV and V); and 2.5% were severe lesions (types VI to IX). The severe lesions were most frequently observed in the left carotid bifurcation (50%) and they first appeared in the age group 45-49 years. Age, hypertension and diabetes mellitus were strong risk factors for atherosclerosis.
Compared with four decades ago there has been an apparent increase in severity and extent of ECCA atherosclerosis especially after the age of 45 years in autopsies from our centre. This change in the amount of atherosclerosis over time is possibly due to the epidemiologic transition. This may worsen the rise in stoke incidence within this community and as such, great effort should be made to follow-up and manage CVD risk factors within the community.
关于尼日利亚人的动脉粥样硬化病变的尸检研究很少，我们中心最近的一次研究是在四十多年前进行的。此外，流行病学也发生了很大的转变。本研究的目的是确定尼日利亚人尸检中颅外颈动脉（ECCA）动脉粥样硬化病变的频率、严重程度、类型和分布。
在一所大学教学医院进行尸检的 30 名连续尼日利亚患者的 ECCA 使用美国心脏协会（AHA）的组织学分级和动脉粥样硬化分类进行检查。
ECCA 的动脉粥样硬化病变在 73.3%的受试者中存在，其中右侧颈动脉分叉处（28.3%）是最常受累的部位。使用 AHA 的动脉粥样硬化分类，共在 240 个血管组织切片中发现了 176 个（73.3%）病变。其中，22.5%为 I 型，22.5%为 II 型，15.4%为 V 型，7.5%为 III 型。VII 至 IX 型病变很少见。当这些动脉粥样硬化病变分为轻度、中度和重度时，52.5%为轻度病变（I-III 型）；18.3%为中度病变（IV 和 V 型）；2.5%为重度病变（VI 至 IX 型）。重度病变最常发生在左侧颈动脉分叉处（50%），并且首先出现在 45-49 岁年龄组。年龄、高血压和糖尿病是动脉粥样硬化的强烈危险因素。
与四十年前相比，我们中心的尸检中 ECCA 动脉粥样硬化的严重程度和范围明显增加，尤其是在 45 岁以上的人群中。随着时间的推移，动脉粥样硬化程度的这种变化可能是由于流行病学的转变。这可能会使该社区中风发病率上升，因此，应努力在社区中随访和管理 CVD 危险因素。
