电镜观察实验性病毒性心肌炎组织改变及其相关因素和治疗探讨

The pathological changes of viral myocarditis observed by electrotelescope and their relationships with associated factors and treatments

目的 探讨病毒性心肌炎不同时期的组织病理改变 ,为临床用药提供理论根据。材料与方法 建立小白鼠柯萨奇病毒B3(CoxB3)心肌炎模型 ,在病程 7、10、14、2 1、2 8、35天 ,分别处死做心脏电镜、病理 ,同时取血测超氧化物歧化酶(SOD)、丙二醛 (MDA)、谷胱甘肽过氧化氢酶 (GSH -PX)及抗心肌抗体。结果 实验性病毒性心肌炎急性期经电镜观察 ,可见线粒体模糊 ,部分嵴空化或消失、Z线模糊 ,肌纤维溶解破坏。病理切片见心肌细胞气球样变性 ,局灶性坏死 ,散在或局部淋巴细胞浸润 ;同时有MDA升高、SOD及GSH -PX降低 ;感染 35天时 ,电镜及光镜下心肌仍有病变 ,可见纤维细胞生成及部分纤维化改变 ,并有心肌抗体升高。但MDA、SOD及GSH -PX恢复正常。结论 病毒性心肌炎急性期应卧床休息、营养心肌及抗氧自由基治疗 ,感染一个月后 ,应偏重抗免疫治疗。此时代表自由基的三种酶已经恢复正常 ,因此 ,抗氧自由基治疗不应超过一个月。

Purpose [WT5”BZ]To study the histological changes in various periods of virus myocarditis(VM)and to provide theory basis for clinical tretment.[WT5”HZ]Materials and methods[WT5”BZ] The models of murine VM caused by coxsakie virus B 3(coxB 3)were established,on the 7th,10th,14th,21th,28th,35th day after incubation.The mice were killed to do pathological electrotelescope and immunohisto-chemical examination of their cardiac tissue.At the same time,we assayed superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),and heart reaction antibody(HRA)in serum.Results[WT5”BZ] The acute period of experimental VM,plasmosome obscure,mitochondrial crista partly cavitation and disappear,z-line obscure,and myolysis were observed by electrotelescope.The pathological changes were balloon denaturation,local necrosis,scattered of local lymphocyte infiltration,and MDA increased,SOD and GSH-pX decreased at the same time.On the 35th day after incubation,there were still myopathologic changes as follows,fibro-cytogenesis and partly fibrosis,and MDA increased as well,but MDA SOD and GSH-pX recovered.[WT5”HZ]Conclusion [WT5”BZ]In acute period,patients should have a rest and were treated with cardiac nutrition and anti-oxygen free radical medication.After one month infected,The treatment should emphasized on anti-immunity.At this time,three enzymes representing oxygen free radical had recovered to normal,so anti-oxygen free radical treatment should be given in no more than one month.[WT5”HZ]