Meyer W W, Lind J
Arch Dis Child. 1972 Jun;47(253):364-72. doi: 10.1136/adc.47.253.364.
Calcific incrustations of the primary internal elastic membrane in the common and internal iliac arteries could be shown grossly by a modified Von Kossa reaction in one-half of all necropsied newborns and infants in the first 4 weeks of life. The calcium content of the Von Kossa positive lesions was verified by Voigt's technique. After the age of 1 year calcific deposits were found in nearly every case. It is unlikely that resorption of these early calcific deposits occurs with growth. The early development of calcific incrustations in the common and internal iliac arteries is obviously related to their position and function in the fetal circulation, i.e. to the higher haemodynamic load which results from the rapid increase in blood flow to the placenta during fetal development, and is associated with an accelerated growth and widening of both vessels. In both iliac arteries only the well-differentiated, thick primary internal elastic membrane becomes calcified in childhood. This membrane is not present throughout the circumference of these arteries, but is developed in certain sectors only. Hence, the predilection site of the calcific incrustations, as well as their gross and microscopical patterns, is determined by the structural peculiarities of both iliac arteries, i.e. by the heterogeneous differentiation of the elastic elements in the vessel's tube. The significance of this heterogeneous structure for the development of later atherosclerotic lesions is still to be evaluated.
在出生后头4周内接受尸检的新生儿和婴儿中，约一半可通过改良的冯·科萨反应大体观察到髂总动脉和髂内动脉原发性内弹性膜的钙化结壳。通过沃伊特技术证实了冯·科萨阳性病变中的钙含量。1岁以后，几乎在每个病例中都发现了钙化沉积物。这些早期钙化沉积物不太可能随着生长而被吸收。髂总动脉和髂内动脉钙化结壳的早期形成显然与其在胎儿循环中的位置和功能有关，即与胎儿发育期间流向胎盘的血流量迅速增加所导致的更高血流动力学负荷有关，并且与这两条血管的加速生长和扩张有关。在儿童期，仅在髂总动脉和髂内动脉中分化良好、较厚的原发性内弹性膜会发生钙化。这种膜并非存在于这些动脉的整个圆周，而是仅在某些区域发育。因此，钙化结壳的好发部位及其大体和微观模式由髂总动脉和髂内动脉的结构特点决定，即由血管壁弹性成分的异质性分化决定。这种异质性结构对后期动脉粥样硬化病变发展的意义仍有待评估。
