摘要
为研究肥厚性心肌病心传导系统的病理改变,作者对10例肥厚性心肌病心传导系统采用纵切法,常规染色切片,光镜下观察,结果发现心传导系统有两种形态学改变:(1)与肥厚性心肌病的心肌相似的变化,即细胞肥大、走向紊乱伴纤维化。(2)房室束分叉部甚至连同左束支起始段牵长变扁、细胞变细、脂肪浸润。以上改变表明,肥厚性心肌病心传导系统变化既有先天性发育异常,也可由于房室束随室间隔肥厚压迫而相应地牵长、变细。肥厚性心肌病患者发生猝死,除因流出道狭窄、冠状动脉灌注不足、左心顺应性降低外,尚需考虑心传导系统病变,导致传导功能障碍,引起严重心律失常。
Thecardiacconductingsystem(CCS)of10casessufferedfromhypertrophiccar-diomyopathyweresampledaccordingtothemodifiedmethoddesignedbytheauthors.TwentytothirtytissuesectionsfromdiferentpartsoftheCCSfromeachcaseweretaken.AlsectionswerestainedbyH&Eandobservedundermicroscope.TwotypesofpathologicalchangesoftheCCSwereobserved.Onewaschangescorrespondingtogeneralchangesinotherpartsoftheheart,suchashy-pertrophyofthemyofibers,disorientationofthecelsandinterstitialfibrosis.TheotherwaschangeswithstretchingandflatteningofthecelsinvolvingthebifurcationoftheAVbundleoreventhecom-mencingportionoftheleftbundlebranch,andfatyinfiltrationoftheseparts.Thesechangesindi-catethatthechangesofCCSincasesofhypertrophiccardiomyopathymaybeduenotonlytoantena-talanomalyoftheheart,butalsotopostnatalhypertrophyoftheinterventricularseptumwithstretchingandflateningofthestructure.Thecauseofsuddenunexpecteddeathsinthesecasescouldbeatributedeithertothenarrowingofoutflowtract,insuficientcoronaryperfusionandloweredcomplianceoftheleftheartasoftendescribed,ortothechangesintheCCSasdescribedinthispa-per,whichleadstoabnormalcardiacconductionandhencetoseverearrhythmia.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1996年第2期143-145,共3页
Chinese Journal of Cardiology
基金
国家自然科学基金
关键词
肥大性
心肌病
心脏传导系统
病理学
cardiomyopathy,hypertrophicheartconductionsystempathology