儿童室性期前收缩心内膜心肌超微结构的改变评价

The Changes of Endocardium and Myocardium Ultrastructure in Children with Ventricular Premature Beat

研究自的 探讨儿童室性期前收缩与心内膜、心肌超微结构变化的关系。 研究设计 对室性期前收缩儿童行心内膜、心肌活检。 患者 8～16岁期前收缩儿童,男6例,女4例。超声心动图、射血分数、生化、兔疫、心脏X线检查(除1例左室轻度增大外)均正常,运动负荷试验阴性。 处理方法 用经改进的 Olympus 显微胃镜活检钳,经股静脉送至右心室。分别在心尖部和室间隔钳取心内膜心肌组织2～3块,光镜和电镜检查。 研究结果 心内膜心肌活检除1例病理基本正常外,9例均有不同程度的心肌心内膜损害。 结论 无症状的室性期前收缩儿童,心内膜心肌活检阳性可做为诊断基础,而阴性也不能除外器质性病变。

Objective To search for the relationship between ventricular premature beat and the changes of endo-cardium and myocardium ultrartructure in Children. Design The endocardium and myocardium biopsies were carried out in children with ventricular prema-ture beat. Patients Ten cases of children with ventricular premature beat, at the age of 8 to 16 years old, 6malesand 4 females. The echocardiogram, ejection fraction, biochemistry, immunology, heart X-ray exa-mination (except for just one case:the left ventricle of heart becomes big lightly) are all in nomal, theexercise tolerance tests are negative. Intervention The improved Olympus microscope biopsy forceps were brought into right ventricle of heartthrough femoral vein.Two or three pieces of endocardium and myocardium tissues taken from cardiac apexand interventricular septum were observed by optical and electron microscope. Result except for just one case, all of 9 cases have pathologic changes of endocardium and myocar-dium in different degree. Conclusions Positive biopsies of endocardium and myocardium may be regarded as diagnostic evide-nce, but the negative can not eliminate organic pathologic changes in children with ventricular prematurebeat without symptoms.