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背景:外径<300μm的阻力小动脉结构与功能改变是缺血性脑血管病的病理基础之一,然而针对不同脑区及不同外径小动脉的定量研究较少。目的:探讨脑梗死后不同部位及不同外径脑小动脉硬化程度的差异。设计:抽样调查。单位:解放军北京军区总医院神经内科。材料:实验标本均取自1980-01/2000-09解放军北京军区总医院自愿捐献的尸体解剖病例,根据临床表现、脑CT检查和尸体解剖病理检查诊断,选取动脉硬化性脑梗死死亡病例38例。非心脑血管性疾病死亡病例15例为对照组。方法:标本均在死后1～3d内取材,选取额、顶叶皮质及底节区白质组织(3块/例),制备切片。每张切片选取5个不同视野,按小动脉外径大小分为<50μm组,50～100μm组及>100μm组。用(外径-内径)/内径,计算血管硬化程度。主要观察指标:①脑梗死组与对照组不同外径小动脉硬化程度。②脑梗死组不同脑区小动脉硬化程度。结果:参加实验的38例动脉硬化性脑梗死死亡病例和15例非心脑血管性疾病死亡病例标本均进入结果分析。①脑梗死组外径<50μm的小动脉硬化指数值明显高于50～100μm组和>100μm组[(138.55±76.67)%,(116.82±58.80)%,(78.07±32.06)%,P<0.01],外径>100μm的小动脉硬化指数值与对照组较接近[(78.07±32.06)%,(46.38±13.41)%,P=0.174]。②脑梗死组白质中<50μm的小动脉硬化指数值明显高于灰质[(152.86±87.83)%,(127.97±64.76)%,P<0.05]。结论:动脉硬化后脑梗死患者小动脉硬化程度与其外径及位置相关,外径小或位于白质的小动脉硬化程度高。
Background: The structural and functional changes of resistance arterioles with external diameter less than 300μm are one of the pathological basis of ischemic cerebrovascular disease. However, the quantitative studies of small artery with different brain regions and different external diameters are few. Objective: To investigate the difference of the degree of sclerosis in different parts and different outer diameters of cerebral arterioles after cerebral infarction. Design: sample survey. SETTING: Department of Neurology, Beijing Military Region General Hospital. MATERIALS: The experimental specimens were collected from the voluntarily donated autopsies of the PLA General Hospital of PLA from January 1980 to September 2000. According to the clinical manifestations, brain CT examination and autopsy pathological examination, 38 cases of atherosclerotic cerebral infarction were selected . 15 cases of non-cardiovascular and cerebrovascular disease deaths as the control group. Methods: The specimens were drawn within 1 ~ 3 days after the death, and the amount, white matter of the parietal cortex and the basal ganglia (3 pieces / case) were selected to prepare the slices. Each slice selected five different fields of vision, according to the size of the small artery diameter <50μm group, 50 ~ 100μm group and> 100μm group. Use (OD - ID) / ID to calculate the extent of vascular sclerosis. MAIN OUTCOME MEASURES: ① The degree of arteriosclerosis of different outer diameters in cerebral infarction group and control group. ② cerebral infarction group different cerebral arteriosclerosis degree. Results: 38 death cases of arteriosclerotic cerebral infarction and 15 death cases of non-cardiovascular and cerebrovascular diseases were involved in the results analysis. (1) The arteriosclerosis index of cerebral infarction group with outer diameter <50μm was significantly higher than that of 50-100μm group and> 100μm group [(138.55 ± 76.67)%, (116.82 ± 58.80)%, (78.07 ± 32.06)%, P <0.01 ], And the index of arteriosclerosis index> 100μm was closer to the control group [(78.07 ± 32.06)%, (46.38 ± 13.41)%, P = 0.174]. ② In the white matter of cerebral infarction group, the value of arteriosclerosis index <50μm was significantly higher than that of gray matter [(152.86 ± 87.83)%, (127.97 ± 64.76)%, P <0.05]. Conclusions: The degree of arteriosclerosis in patients with cerebral infarction after atherosclerosis is related to their OD and location, and the degree of arteriosclerosis with small OD or white matter is high.