围产期心肌病的组织学及亚微结构改变

作者观察1例尸检,2例活检的心肌组织,发现围产期心肌病的组织学改变为灶状肌溶性坏死,病灶呈全心分布,以左室内侧密集且趋向融合,间质未见炎性渗出反应。取右室心肌活检电镜观察,可见心肌细胞有两种变化:一为肌原纤维的灶状溶解脱失,一为肌纤维内絮斑状电子密度物质沉积。闰盘呈各种变异及间隙加宽。作者未发现心肌细胞质内有任何其他沉积物,电镜下也未见任何异常的微丝聚集及高电子密度团块。通过观察,作者同意本病属多因素综合症的说法,其病变可能为机体免疫状态发生变化所导致的变应性心肌病。

HISTOPATHOLOGIAL AND ULTRASTRUCTURAL CHANGES IN PERIPARIUM CARDIOMYOPATHY

Thi spaper reports 3 cases of peripartum cardiomyopathy(autopsy 1 case, biopsy 2 cases) All of their three patients were multipara of 26—27 years old. This papes mainly introduces the pathological features of the heart. Electron microscopic observation on endomyocardial biopsy specimen taken from right ventricles revealed that the pathologic changes of cardiac muscle cells can assume two forms: the first type is characterized by minute focal myofibrillar lysis involving some myofibrillae or almost the whole myoeardiac cell; the second type is manifested by electron dense materials deposition with spot appearance in the myc- cardiac cytoplasm. Intercalatcd discs show a variety lesicns. By LM and EM, we did not find any other deposits and other microfilaments aggregation in myocardiac cells. According to the histopathological and ultrastructural features as mentioncd above, peripartum cardiomyopathy may be an allergic degenerative cariomyopathy with deparenchemazation as its main lesion. It is postulated that peripartum cardiomyopathy may be a multifacter syndrome.