潜在型克山病患者心内膜心肌活检的亚微结构改变

1988年对陕西旬邑县12例潜在型克山病作心内膜心肌活检电镜观察,并用镧颗粒示踪探索心肌细胞膜通透性变化。检材取自7例男性、5例女性患者,年龄14～40岁,平均病史已达4～5年。观察结果:大部心肌细胞肌浆网、横管系统扩张,闰盘也见类似囊泡状扩张改变。部分病例样品中可见镧颗粒出现于闰盘间隙和细胞质内。线粒体增生及退变性变化同时并存。细胞内肌微丝偶见微小的肌溶中断,但未发现心肌细胞的肌溶坏死。部分细胞核增大、扭曲变形,有假包涵体。部分肌原纤维增粗有异常分枝。此外,并见心肌细胞内脂滴增多,糖元沉积以及核周脂褐素颗粒堆积。

ULTRASTRUCTURAL CHANGES OF ENDOMYOCARDIAL BIOPSY FROM PATIENTS WITH LATENT KESHAN DISEASE

Twelve patients with latent Keshan disease in Xunyi County,Shaanxi Province were electron-microscopically observed with endomyocardial biopsy. Seven of them were males, 5 females; their ages ranged from 14 to 40 years old. They had suffered from the disease for 4 to 5 years in an average. The samples taken from their heart ventricles were prepared in routine,some were prepared with the modified lanthanum preparation according to Hoffstein's method to study the membrane permeability of the patients' myocardium at the same time,In almost all the samples, most of sarcoplasmic reticula,transverse tubule system and intercalated disc spaces are dilated. In some samples prepared with the lanthanum preparation, the electronic density particles are found in the intercalated disc spaces and scarcely in the cytoplasm of myocardium. Mitochondria often show changes both of proliferation and of degeneration simutaneously. Sometimes, minimal myolytic changes of filaments also can be seen, but there are no any necrotic or myolytic foci of myocardium found in the samples at all. Some nuclei are enlarged and twised,in them some pseudoinclusions also can be occasionally seen. Myofibrils vary their thickness. At the same time, they also have some abnormal branches. More than normal amount of fat droplets and glycogen granules deposite in the myocardial cells. Besides,there are lots of lipofusicin granules accumulated around the nuclei in the cytoplasm.