慢性肺心病肺心组织的超微结构观察及其临床意义

Ultrastructural observation and its clinical significance on the lungs and hearts in chronic cor pulmonale

利用透射电镜观察尸检慢性肺心病肺泡组织１０例及心肌组织６例。结果发现：肺泡上皮细胞肿胀、坏死、肺泡Ⅱ型上皮增生、肺泡间质纤维性增厚、肺毛细血管内皮细胞肿胀、血管床减少等可能是呼吸循环衰竭的形态基础。在右心室、左心室均可见心肌细胞线粒体肿胀、肌原纤维灶性溶解、糖原减少、肌浆网和Ｔ小管扩张；心肌细胞核肿胀和心肌毛细血管内皮细胞肿胀等等；结合尸检可见左室肥大，因此认为肺心病累及右心室为主，也可以累及左心。

The lungs of ten cases and six hearts from patients with chronic cor pulmonale were observed by light and electron microscopy.These lungs revealed the swelling and necrosis of the alveolar epithelial cell and the endothelial cell,swelling of mitochondria with vacuole formation and dilation of some endoplasmic reticulum in the alveolar epithelial cells and the endothelial cells,proliferation of type Ⅱepithelial cell,and interstitial fibrous hyperplasia.There were similar pathologic changes in the left and right cardiac ventricles,and mitochondria showed clearing of the matrix and destruction of the crista,dilation of endoplasmic reticulum in the myocadial cells,and focal necroses in the myofilaments.Left ventricular hypertrophy was seen in our autopsy cases.It is suggested that the left and right ventricle might be involved in chronic cor pulmonale.