Pasterkamp G, Schoneveld A H, van der Wal A C, Haudenschild C C, Clarijs R J, Becker A E, Hillen B, Borst C
Department of Cardiology, Utrecht University Hospital, Interuniversity Cardiology Institute of The Netherlands.
J Am Coll Cardiol. 1998 Sep;32(3):655-62. doi: 10.1016/s0735-1097(98)00304-0.
To relate local arterial geometry with markers that are thought to be related to plaque rupture.
Plaque rupture often occurs at sites with minor luminal stenosis and has retrospectively been characterized by colocalization of inflammatory cells. Recent studies have demonstrated that luminal narrowing is related with the mode of atherosclerotic arterial remodeling.
We obtained 1,521 cross section slices at regular intervals from 50 atherosclerotic femoral arteries. Per artery, the slices with the largest and smallest lumen area, vessel area and plaque area were selected for staining on the presence of macrophages (CD68), T-lymphocytes (CD45RO), smooth muscle cells (alpha-actin) and collagen.
Inflammation of the cap or shoulder of the plaque was observed in 33% of all cross sections. Significantly more CD68 and CD45RO positive cells, more atheroma, less collagen and less alpha-actin positive staining was observed in cross sections with the largest plaque area and largest vessel area vs. cross sections with the smallest plaque area and smallest vessel area, respectively. No difference in the number of inflammatory cells was observed between cross sections with the largest and smallest lumen area.
Intraindividually, pathohistologic markers previously reported to be related to plaque vulnerability were associated with a larger plaque area and vessel area. In addition, inflammation of the cap and shoulder of the plaque was a common finding in the atherosclerotic femoral artery.
将局部动脉几何结构与被认为与斑块破裂相关的标志物联系起来。
斑块破裂常发生在管腔轻度狭窄的部位，回顾性研究表明其特征为炎症细胞的共定位。最近的研究表明，管腔狭窄与动脉粥样硬化性动脉重塑模式有关。
我们从50条动脉粥样硬化股动脉中定期获取1521个横截面切片。对于每条动脉，选择管腔面积、血管面积和斑块面积最大及最小的切片，用于检测巨噬细胞（CD68）、T淋巴细胞（CD45RO）、平滑肌细胞（α-肌动蛋白）和胶原蛋白的存在情况。
在所有横截面中，33%观察到斑块帽或肩部存在炎症。与斑块面积和血管面积最小的横截面相比，在斑块面积和血管面积最大的横截面中，分别观察到显著更多的CD68和CD45RO阳性细胞、更多的粥样硬化、更少的胶原蛋白和更少的α-肌动蛋白阳性染色。在管腔面积最大和最小的横截面之间，未观察到炎症细胞数量的差异。
在个体内部，先前报道的与斑块易损性相关的病理组织学标志物与更大的斑块面积和血管面积相关。此外，斑块帽和肩部的炎症在动脉粥样硬化股动脉中是常见现象。
