心内膜心肌活检诊断价值的临床研究

A CLINICA STUDY ON THE DIAGNOSTIC EVALUATION IN ENDOMYOCARDIAL BIOPSY

对90例心脏病患者进行心内膜心肌活检(EMB)95例次,成功率96.8%,临床诊断原因不明心律失常44例,各型心肌病24例,疑诊心肌炎10例,先心并心律失常4例,缩窄性心包炎5例,二尖瓣脱垂3例,经光、电镜检查确定诊断72例(80%)。其中心肌炎44例,扩张型心肌病19例、肥厚型1例,限制型4例,炎性心肌病4例。排除诊断3例(3.4%),无助于诊断15例(16.6%)。全组均无严重并发症,作者认为EMB对心肌疾病(尤其对心内膜心肌纤维化病)及心肌炎有较大诊断价值的新技术,值得推广。

Right Ventricular endomyocardial biopsy was performed 95 times in 90 patients,in which two to three separate samples of cardiac tissue were obtained from the right side of the interventricular septum.The biopsy samples of each patient were examined under light microscope and electron microscope.The successful rate was 96.8%.The of the patients was as follows:arrhythmia of unknown etiology 44 cases,Cardiomyopathy 24 cases, Suspicious of myocarditis 10 cases,congenital heart disease with arrhythmia 4 cases,Constrictive pericarditis 5 cases,mitral valve prolapse 3 cases. The Clinical diagnosis of 72 patients(80%)was confirmed by microscopic chamination,in which:forty four cases were myocarditis,nineteen were dilated cardiomyopathy,one was hypertrophic cardiomyopathy,four were restrictive cardiomyopathy.and four were inflammatory cardiomyopathy.The clinic al diagnosis was excluded by biopsy examination in three patients (3.4%),and there were 15 cases(16.6%)in which endomyocardial biopsy was 8 not much help.There were no serious complications or death.Thus, endomyocardial biopsy is a useful diagnostic technique for myocardium disease especially endomyocardial fibrosis and myocarditis.