微栓子与不稳定性心绞痛症状的关系探讨

The relationship between microemboli and unstable angina

目的 探讨微栓子在不稳定性心绞痛发生中的作用。方法 10例心脏标本取自急性心肌梗死死亡病例 ,生前有典型不稳定性心绞痛症状。心脏固定后完整剥离冠状动脉 ,冠状动脉经脱钙后每隔 3～ 4mm连续取材 ,从心尖至房室交界按冠状面每隔 4～ 5mm切成大组织片 ,然后将组织片全部取材。冠状动脉和心肌组织块经常规HE染色后显微镜下观察血栓和心肌内小血管微栓子。同时对 10例年龄相当的稳定性心绞痛死亡患者的心脏做对照研究 ,研究方法同上。结果 10例不稳定性心绞痛病例中 9例心肌内小血管中检出微栓子 ;而稳定性心绞痛组仅 1例查见微栓子。两组比较差异具显著性 (P <0 0 1)。不稳定性心绞痛与稳定性心绞痛组冠状动脉内血栓检出率之比为 9∶1,差异有显著性 (P <0 0 1)。结论 不稳定性心绞痛患者心肌内微栓子明显多于稳定性心绞痛。

Objective To demonstrate the possible role of microemboli in the occurrence of unstable angina Methods The coronary arteries and myocardium of ten autopsy cases died of acute myocardial infarction were studied All the ten patients were diagnosed unstable angina before death After fixation, the coronary arteries were removed bloc and serially cut at an interval about 4mm The hearts were cut coronally from apex to bottom at an interval of 4mm, then all the myocardial slices were divided into blocks HE slides were made for all blocks and observed under microscope Results Microemboli were found in 9 of the total 10 unstable angina cases, while only in one case of the ten control stable angina cases The difference was significant (P<0 01) The occurrence rate of thrombi in unstable and stable angina cases was 0 9 versus 0 1 The difference was also significant (P<0 01) Conclusion There were more microemboli of the myocardium in unstable angina than that in stable angina cases The microemboli may be one of the causes of unstable angina