心脏传导系统淀粉样变

The amyloidosis in cardiac conduction system

目的研究心脏淀粉样变患者出现心律失常心力衰竭与心传导系统淀粉样变的关系。方法用本组建立的心脏传导系统检查法，刚果红染色、偏振光显微镜观察了６例淀粉样变的心脏传导系统。结果６例心脏淀粉样变者，心传导系统病变以窦房结最重，房室传导系统轻，后者有由近（房室结）至远部（左束支）逐渐加重倾向，其中３例有窦性心动过缓和传导阻滞者，心传导系统病变广布且严重。结论心传导系统淀粉样变可以是心律失常的病理基础之一。

Objective To investigate the relationship between arrhythmia, cardiac failure and amyloidosis of cardiac conduction system (CCS). Methods CCS from 6 cases with cardiac amyloidosis were sampled using technique designed by the authors. The CCS were studied by Congo red staining and polarization microscopy. Results Pathological changes could be found in the CCS of these 6 cases. It was serious in sino atrial node while slight in atrio ventricular conduction system. The changes in atrio ventricular conduction system were exacerbated from proximal part (atrio ventricular node) to distal part (left bundle branch). In the 3 cases with sinus bradycardia and conduction blocking manifested by electrocardiogram, the pathological changes in CCS were more extensive and serious than that of other cases. Conclusion The amyloidosis in CCS is one of the pathological bases of arrhythmia.