克山病心内膜—心肌活检及血液动力学检查8例报告

本文报告了8例克山病病人心内膜—心肌活检和心导管法血液动力学研究的经验。全部病人的操作过程均顺利,安全,无合并症发生。所有病例都获得了心内膜—心肌组织。经光镜及电镜观察心内膜均正常。心肌均发现异常形态学改变,如:心肌变性、心肌纤维肥大、陈旧性瘢痕等。有4例病人发现心肌间质脂肪组织浸润。心导管检查:8例中的2例潜在型克山病结果正常,6例慢型中的5例有肺动脉压力增高,其中2例有明显的肺动脉高压。作者对以上问题作了初步的讨论,并认为心内膜—心肌活检是一个能提供心肌病理情况的良好方法,对于诊断、预后具有较大价值。

ENDOMYOCARDIAL CATHETER BIOPSY AND HEMODYNAMIC OBSERVATION IN KESHAN DISEASE--A REPORT OF 8 CASES

Endomyocardial biopsy and hemodynamic study were made with the heart catheterization in 8 patients with Keshan disease. The procedure was performed smoothly and safely in all patients, without complications. Endomyocardial tissues were obtained from these eight patients. Light and electronmicroscopic observations showed that the endocardium is normal in all biopsy specimens, but abnormal morphologic findings, such as degeneration of the myocardiaum, hypertrophy of muscle fibers, old scars, etc., were present in all patients. Infiltration of interstitial fatty tissue was found in 4 cases. Heart catheterization. 2 patients with latent Keshan disease were normal. There was an increase in the pulmonary arterial pressure in 5 out of 6 patients with chronic type, and 2 showed distinct pulmonary arterial hypertension. Thus, endomyocardial biopsy may be regarded as a better method to examine the myocardium, and it is of value in diagnosis and prognosis.