病毒性心肌炎及扩张型心肌病心内膜心肌活检组织的病理学观察

Histopathologic Observations on Endomyocardial Biopsy Specimens from Patients with Viral Myocarditis and Dilated Cardiomyopathy

本文对35例病毒性心肌炎(VMC)和10例扩张型心肌病(DCM)心内膜心肌活检(EMB)标本进行病理组织学观察,发现主要病理改变 DCM 为心肌细胞肥大、细胞大小不一、核畸形、灶状纤维化和心肌变性坏死;VMC 则为炎性细胞浸润、心肌变性坏死、间质纤维化。EMB 病理诊断与临床诊断符合率 VMC 为65.7%,DCM 为80.0%,合计68.8%。

The endomyocardial biopsy(EMB)specimers from patients with suspected vi-ral myocarditis(VMC,35 cases)and dilated cardiomyopathy(DCM,10 cases)were evalu-ated histopathologically.The results revealed that the main histopathologic changes in DCMwere hypertrophy of myofibers,apparent variation in myocyte size,nuclear changes,focalfibrosis and myocyte degeneration,and those in VMC were inflammatory infiltrate,myocytedegeneration and interstitial fibrosis.The secondary pathological changes in VMC were in-terstitial hemorrhage and edema.The histopathological diagnoses were coincident with clini-cal diagnoses in 68.8% of all patients(65.7% of patients with VMC and 80.0% of patientswith DCM).The significance of sequential EMB in the treatment,prognosis and pathogenicmechanism of myocardial diseases was confirmed.However,EMB has its limitations inpathological diagnosis of VMC and DCM.