Mautner S L, Lin F, Mautner G C, Roberts W C
Pathology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892.
J Am Coll Cardiol. 1993 May;21(6):1312-8. doi: 10.1016/0735-1097(93)90302-h.
This study quantifies and compares the components of atherosclerotic plaques in native coronary arteries and in saphenous vein grafts used for aortocoronary bypass surgery in women versus those in men.
Plaque composition has been described in various manifestations of fatal coronary artery disease and after the bypass operation, but no reports have investigated this composition according to gender.
A total of 979 5-mm segments of native coronary arteries and 842 5-mm segments of saphenous vein grafts were examined by computerized planimetric technique in 11 women and 11 men who were matched for survival time after the bypass operation.
Comparison of the plaque components revealed that atherosclerotic plaques in women, compared with those in men, contained significantly more cellular fibrous tissue, both in native coronary arteries (mean 38% vs. 4%, p < 0.001) and in saphenous vein grafts (mean 70% vs. 36%, p < 0.05). In contrast, the proportion of dense fibrous tissue was significantly less in the atherosclerotic plaques of women than in those of men, both in native coronary arteries (mean 50% vs. 85%, p < 0.001) and in saphenous vein grafts (mean 25% vs. 57%, p < 0.05).
Cellular fibrous tissue is often found at an early stage of plaque development, whereas dense fibrous tissue is a major component in later stages. Thus, the plaque composition of the native coronary arteries and saphenous venous conduits differed in men and women, with the plaques of the women appearing younger than those of the men.
本研究对女性和男性用于主动脉冠状动脉搭桥手术的自体冠状动脉及大隐静脉移植物中动脉粥样硬化斑块的成分进行量化和比较。
斑块成分已在致命性冠状动脉疾病的各种表现形式及搭桥手术后有所描述，但尚无根据性别对该成分进行研究的报告。
采用计算机平面测量技术，对11名女性和11名男性的979段5毫米长的自体冠状动脉节段及842段5毫米长的大隐静脉移植物节段进行了检查，这些受试者在搭桥手术后的生存时间相匹配。
斑块成分比较显示，与男性相比，女性的动脉粥样硬化斑块含有显著更多的细胞纤维组织，无论是在自体冠状动脉中（平均38%对4%，p<0.001）还是在大隐静脉移植物中（平均70%对36%，p<0.05）。相比之下，女性动脉粥样硬化斑块中致密纤维组织的比例显著低于男性，无论是在自体冠状动脉中（平均50%对85%，p<0.001）还是在大隐静脉移植物中（平均25%对57%，p<0.05）。
细胞纤维组织常在斑块发展的早期阶段出现，而致密纤维组织是后期阶段的主要成分。因此，男性和女性的自体冠状动脉及大隐静脉管道中的斑块成分不同，女性的斑块看起来比男性的更年轻。
