成人高原性心脏病18例临床病理观察

A CLINICOPATHOLOGIC OBSERVATION OF HIGH ALTITUDE HEART DISEASE IN 18 ADULT CASES

报道了18例成人高原性心脏病病理形态学变化,总结了本病的临床病理特点和诊断依据及其与克山病、冠心病等的鉴别诊断。本组资料中,汉族17例,藏族1例;男17例,女1例;移居高原1～8年;驻地海拔3000～5000m。心脏体积增大,重量增加,400～500g13例,双室肥厚14例。镜下观察心肌坏死和瘢痕主要见于左右室乳头肌(15/18)和左右心室壁(9/10)。因此,慢性缺氧对心肌的损害值得重视,临床早诊断早治疗尤为重要。

This paper reports pathologic changes in 18 cases of high altitude heart disease in adult. Its cli-nicopathological features, diagnostic criteria and differential diagnosis from Ke-shan disease, coronary heart disease and hypertensive heart disease were discussed.Of the 18 patients, 17 were Hans, and 17 were males. The Hans had settled in high altitude(3658-5000m) for 1-8 years. The hearts were enlarged and increased in weight. They weighed 400-510g in 13 cases. Both ventricles were hypertrophic in 14 cases. Microscopically, necrosis and scarring were found mainly in the papillary muscles (15/18) and the ventricular wall (9/10) of the right and left ventricles.As regards the pathogenesis, the auther believes that myocardial damage due to chronic hypoxia should be stressed. Early diagnosis and treatment are important.