Kimura Hiroaki, Takao Masaki, Suzuki Norihiro, Kanemaru Kazutomi, Mihara Ban, Murayama Shigeo
Department of Neurology, School of Medicine, Keio University, Tokyo, Japan; Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Brain Bank for Aging Research, Tokyo, Japan; Department of Neurology, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Gunma, Japan.
Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Brain Bank for Aging Research, Tokyo, Japan; Department of Neurology, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Gunma, Japan; Department of Neurology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan.
J Stroke Cerebrovasc Dis. 2017 Dec;26(12):2821-2827. doi: 10.1016/j.jstrokecerebrovasdis.2017.06.056. Epub 2017 Jul 26.
Atherosclerotic changes in the cerebral arteries may differ with era of birth. Herein, we analyzed the chronological changes of intracranial atherosclerosis in consecutive autopsy cases.
A total of 7260 autopsy cases from 1972 to 2014 were analyzed. Severity of atherosclerosis was classified using a semi-quantitative scale of pathologic observation of each artery after formalin fixation: 0 = no stenosis; .5 = fatty streaks but no stenosis; 1 = <50% stenosis; 2 = 50%-90% stenosis; 3 = ≥90% stenosis. The bilateral vertebral, anterior, middle, and posterior cerebral arteries and the basilar artery were scored. The sum of each individual was defined and compared by age at death, sex, and era of birth.
The atherosclerosis score increased with age at death, as follows: age in the 50s, 0 [0-2]; 60s, 3 [.5-7]; 70s, 5 [2-9.5]; 80s, 6.5 [3.5-11.5]; 90s, 7.75 [4-12]; and 100s, 8 [5.5-13.5] (median value [interquartile range], P< .0001). The percentage of cases with a score of 2 or 3 in each artery also increased with age (P< .0001). Atherosclerosis score was higher in men than women in their 60s at death, and was higher in women than men in their 80s and 90s at death. In each age at death group (from 60s to 100s), the score declined with later year of birth (P < .05).
Intracranial atherosclerosis advances with age and is more severe in subjects born earlier.
脑动脉的动脉粥样硬化变化可能因出生年代而异。在此，我们分析了连续尸检病例中颅内动脉粥样硬化的时间变化。
对1972年至2014年的7260例尸检病例进行分析。动脉粥样硬化的严重程度采用福尔马林固定后对每条动脉进行病理观察的半定量量表进行分类：0=无狭窄；.5=脂肪条纹但无狭窄；1=<50%狭窄；2=50%-90%狭窄；3=≥90%狭窄。对双侧椎动脉、大脑前动脉、大脑中动脉、大脑后动脉和基底动脉进行评分。计算每个个体的总分，并按死亡年龄、性别和出生年代进行比较。
动脉粥样硬化评分随死亡年龄增加，如下：50多岁，0[0-2]；60多岁，3[.5-7]；70多岁，5[2-9.5]；80多岁，6.5[3.5-11.5]；90多岁，7.75[4-12]；100多岁，8[5.5-13.5]（中位数[四分位间距]，P<.0001）。每条动脉评分2或3的病例百分比也随年龄增加（P<.0001）。死亡时60多岁的男性动脉粥样硬化评分高于女性，死亡时80多岁和90多岁的女性动脉粥样硬化评分高于男性。在每个死亡年龄组（从60多岁到100多岁），评分随出生年份越晚而下降（P<.05）。
颅内动脉粥样硬化随年龄进展，且在出生较早的人群中更严重。
