Velican D, Velican C
Atherosclerosis. 1980 Aug;36(4):449-60. doi: 10.1016/0021-9150(80)90238-5.
Coronary atherosclerotic plaques were revealed by light microscopy in 12% of adolescents and in 28% of young adults. All the plaques of adolescents and one-third of the plaques of young adults escaped recognition on ordinary gross inspection, even after Sudan staining. A centrifugal extention of plaques, from the branching areas to the proximal segment of the main coronary arteries took place, starting from adolscence. During early adulthood this centrifugal extension continued involving the intermediate segments of the anterior descending and right coronary arteries. In undistended vessels, the coronary atherosclerotic plaques narrowed the lumenal diameter up to 55% in adolescents and up to 65% in young adults. Histologically, the mucoid type of plaque, rich in areas of edema, insudate and depolymerized ground substance, prevailed in the coronary arteries of adolescents; in young adults, the prevalent plaque was the lipid-rich variety, containing many clusters of lipid-filled and foam cells. In addition, necrotic plaques or atheromas have been revealed for the first time in young adults. A positive association appeared on our material between cigarette smoking and the presence of mucoid plaques in the proximal segment of the main coronary arteries of adolescents. On the other hand, no relation could be established between risk factors and the accumulation of lipid-filled and foam cells in the atherosclerotic plaques of young adults.
光学显微镜检查发现，12%的青少年和28%的年轻人存在冠状动脉粥样硬化斑块。所有青少年的斑块以及三分之一年轻人的斑块，即便经过苏丹染色，在普通大体检查中仍无法识别。从青少年时期开始，斑块就会从分支区域向冠状动脉主干近端呈离心性扩展。在成年早期，这种离心性扩展继续，累及前降支和右冠状动脉的中间段。在未扩张的血管中，青少年的冠状动脉粥样硬化斑块使管腔直径缩小达55%，年轻人则达65%。组织学上，青少年冠状动脉中以富含水肿、渗出物和降解基质区域的黏液样斑块为主；在年轻人中，主要是富含脂质的斑块，含有许多脂质填充细胞和泡沫细胞簇。此外，在年轻人中首次发现了坏死斑块或粥样瘤。在我们的研究材料中，青少年主要冠状动脉近端的黏液样斑块与吸烟呈正相关。另一方面，在年轻人的动脉粥样硬化斑块中，危险因素与脂质填充细胞和泡沫细胞的积聚之间未发现关联。
