The Initial Study Of The Characteristics Of Carotid Plaque And Its Clinical Significance In Carotid Atherosclerosis Stenosis Patients

Objective:The instability of atherosclerotic plaque is the leading pathogenesis of clinical incident resulting in plaque rupture and ulcer which caused thrombosis formation and/or embolism.The aim of this study is to investigate the relation between the percentage of carotid stenosis,characteristics of carotid plaque and clinical symptoms on patiems with carotid atherosclerosis stenosis(CAS).The pathologic factors which influence on unstable plaques were also analysed.Methods:24 Carotid endarterectomy(CEA)patients were divided into 2 groups according to NASCET criteria:Symptomatic and Asymptomatic.(1)compare the degree of carotid stenosis in two groups.(2)After CEA,the specimens of plaque were sectioned(4μm) longitudinal every 1.0ram.According to the area of lipid-rich necrotic core measure under optical-microscope,the specimens were divided into stable and unstable plaque groups.(3)All sections were stained with an anti-NF-kBp50 antibody(clone,dilutionl:50).Macrophages were stained with anti-CD68 antibody(clone PG-M1,DAKO,dilution 1:100). Neovascularisation were stained with anti-CD105 antibody(clone SN6h, Macrophages and Neovascularisation on the both groups.Moreover to explore the factors influence on unstable plaque.Results:(1)14 patients were in Symptomatic group and 10 patients in Asymptomatic group.The percentage of carotid stenosis in symptomatic group is 84.83±12.94%,the Asymptomatic group is 77.00±17.56%,there were no significant statistical differences between two groups.(2)10 plaque specimens were in stable plaque group and 14 were in unstable plaque group.We found 11 unstable plaques and 3 stable plaques in Symptomatic group,3 unstable plaques and 7 stable plaques in Asymptomatic group.The unstable plaque were significant higher in Symptomatic group than in Asymptomatic group.There were statistical significance(p=0.024＜0.05).(3)The thickness of fibrous cap in stable plaque group was 49.19±8.88,in unstable plaque group was 38.51±5.39.There were statistical significance between the two groups.(4)The result of immunohistochemistry stain:The expression of NF-KBp50 were simillar in stable groups and unstable groups(p=0.25). The expression of Macrophages were significantly higher in unstable group(85474.66±7797.10) than stable group(45025.05±6913.79).The expression of Neovascularisation focus on plaque shoulder and lipid-rich core.The expression were 24413.38±8539.36 in stable group and 59132.52±10215.79 in unstable groups.There were statistical significance(p=0.019).Conclusion:(1)In our study,the instability of carotid plaque is involve the clinical cerebral vascular attack.(2)The Macrophages and Neovascularisation were one of factors which caused instability of plaque.(3)The thickness of fibrous cap may indicate the plaque's stabilization.