Hangartner J R, Charleston A J, Davies M J, Thomas A C
Br Heart J. 1986 Dec;56(6):501-8. doi: 10.1136/hrt.56.6.501.
All segments of clinically significant stenosis in the coronary arteries of 54 men with stable angina were categorised according to the position of the plaques (eccentric or concentric) and the presence or absence of a pool of extracellular lipid. In the group as a whole, stenosis of greater than 50% by diameter was caused by concentric fibrous plaques in 48% of lesions, by concentric lipid plaques in 28%, by eccentric fibrous plaques in 12%, and by eccentric lipid plaques in 12%. In addition, 43 of the 54 patients had one or more stenoses with multiple channels (recanalisation). Eccentric plaques with an arc of normal vessel wall occupying more than 16% of the circumference of the residual lumen were considered to have a vasospastic potential and made up 15% of all lesions with stenosis of greater than 50% by diameter. Forty four per cent of plaques causing stenosis between 30% and 50% by diameter were eccentric and retained a considerable arc of normal media. These lesions were often in series with segments of higher grade stenosis that did not have an arc of normal media. The overall frequency of plaque types gave no indication of the proportions of different plaque types within an individual. In 15% of patients all the plaques causing greater than 50% diameter stenosis were fibrous and in 13% of patients all the plaques were of the lipid type. Most patients had mixtures of all plaque types in varying proportions. Plaques with a large pool of lipid were not found in 33% of patients whereas they formed greater than 90% of the plaques in 9% of patients. No segments of stenosis > 50% by diameter with a vasospastic potential were found in 44% of the patients but one or more such plaques was present in the the remaining 56%. Three patients (6%) each had five separate segments of stenosis with a vasospastic potential. The results indicate that even in a population of men with stable angina in whom diabetes is excluded the distribution of types of atheromatous lesions is very heterogenous.
对54例稳定型心绞痛男性患者冠状动脉中具有临床意义的狭窄节段，根据斑块位置（偏心或同心）以及细胞外脂质池的有无进行分类。在整个组中，直径大于50%的狭窄由同心纤维斑块导致的占48%的病变，由同心脂质斑块导致的占28%，由偏心纤维斑块导致的占12%，由偏心脂质斑块导致的占12%。此外，54例患者中有43例存在一个或多个具有多通道（再通）的狭窄。偏心斑块若其正常血管壁弧占据残余管腔周长超过16%，则被认为具有血管痉挛潜能，在所有直径大于50%的狭窄病变中占15%。导致直径30%至50%狭窄的斑块中，44%为偏心斑块且保留了相当长一段正常中膜弧。这些病变常与无正常中膜弧的更高等级狭窄节段串联。斑块类型的总体频率并未表明个体内不同斑块类型的比例。15%的患者中，所有导致直径大于50%狭窄的斑块均为纤维性，13%的患者中所有斑块均为脂质类型。大多数患者具有不同比例的所有斑块类型混合。33%的患者未发现有大量脂质池的斑块，而9%的患者中此类斑块占斑块总数的90%以上。44%的患者未发现直径大于50%且具有血管痉挛潜能的狭窄节段，但其余56%的患者存在一个或多个此类斑块。3例患者（6%）各有5个独立的具有血管痉挛潜能的狭窄节段。结果表明，即使在排除糖尿病的稳定型心绞痛男性人群中，动脉粥样硬化病变类型的分布也非常不均一。
