人心传导系统纵切取材法及组织学观察

HISTOLOGIC STUDY AND NEW SAMPLING METHOD OFCONDUCTING SYSTEM IN HUMAN HEART

为研究心脏传导系统（ＣＣＳ）增龄性变化、病理改变及其与猝死的关系，在前人基础上建立了一种简便的ＣＣＳ取材方法。采用与窦房结（ＳＡＮ）、房室结（ＡＶＮ）长轴平行的纵切取材法，切取１４４例１０％福尔马林液固定、不同年龄非心性疾病死亡者心脏标本。该法具有如下特点：（１）ＣＣＳ定位标志清楚，故能准确取材；（２）ＳＡＮ、ＡＶＮ纵轴比横轴长２～３倍，故沿纵轴切片的数量远比横切法少；（３）可在一张切片上观察到更多传导组织及其周围构筑；（４）该法简便、实用，可推广应用于病理常规检查ＣＣＳ。组织学观察：年龄少于１０岁，传导组织间质极少；随年龄递增，其间质（胶原纤维为主，及脂肪组织、弹力纤维和网状纤维）逐渐增多，而主质细胞（起搏细胞、移行细胞）相对减少；ＳＡＮ纵切最大面积是在青壮年期（２０～４０岁），且呈现增龄性结构变化。

144 samples of formalin fixed human hearts of various ages(20 weeks gestation～90 years old)were cut longitudinally using the new method parallel to the humanong axis of the SAN(sinoatrial node)and AVN (atrioventricular node).It differs from traditional methods in the following aspects.(1) The landmarks of cardiac conducting system(CCS)are clear,so the site of CCS can be located easily and accurately. (2) The long axis of the SAN,AVN are 2 3 times greater than their transverse axis.Therefore,it will reduce the number of series sections along their long axis compared to those along the transverse axis.Accordingly,the work load for preparing sections is much less than that of traditional methods.(3) The whole structure of the node and its surrounding tissue can be seen more visibly in a single section. (4) It is convenient and practical,then could be popularized for routine examination of CCS in forensic and pathologic practice.Histologic observasion of CCS:<10 years old,the intersitium is very less.There are increasing in collagen,elastic fibers and fatty tissue with aging.The longitudinal areas of SAN,AVN are maximum in 20 40 years old.