糖尿病患者心内膜下心肌的超微结构改变

Ultrastructural Changes of Subendocardial in Diabetic Patients

通过对１１例糖尿病患者心内膜下心肌活检的超微结构研究，发现部分心肌细胞肌原纤维排列紊乱，甚至局部消失；胞浆内有脂褐素、糖原颗粒沉积及脂滴浸润．线粒体增生、变性，出现巨线粒体；横小管肥大，横小管内有絮状物沉积．７例不伴有并发症的糖尿病患者中有６例可见心肌间的毛细血管基膜增厚．其中３例的心肌间质出现轻度纤维化．本研究认为糖尿病患者在心肌细胞代谢紊乱基础上形成的心肌微血管病变在糖尿病性心肌病变中起主要作用．

The subendocaldial myocardium of 11 diabetic petients showed focal disarray and disappearance of myofibrils with the existence of lipofuscins. glycogen granules and lipid droplets in the sarcoplasmThe mitochondria were proliferated or deteriorated. The transverse tubules dilated with wadding inclusion.Among 7 diabetic patients without complications, 6 cases showed focal thickness of capillary basal laminae,3cases showed slight interstitial fibrosis. The results suggested that microangiopathy induced by the metabolicdefect played an important role in diabetic cardiomyopathy.