CAJ | 학술논문

目的探讨心肌致密化不全的临床病理特征.方法收集5例心肌致密化不全患者的临床症状、体征、心电图及超声心动图情况,测量心脏的大体情况,包括心脏的重量、纵长、横宽及各瓣膜环的长度、心室流人道和流出道的长度、心室壁的厚度.常规制片,磷钨酸苏木精染色、弹力纤维染色,光镜观察心肌情况及冠状动脉的改变.结果 5例患者均为男性,29-57岁,临床均有胸闷症状,心电图显示心律失常,超声心动图检查3例诊断为心肌致密化不全,病理分析可见受累心腔内显示有异常粗大的肌小梁和交错深陷的隐窝,从心底到心尖致密心肌逐渐变薄;心内膜为增厚的纤维组织,内层非致密心肌肌束粗大紊乱、细胞核畸形,外层致密心肌肌束走行及形态基本正常,细胞核大小均匀.结论心肌致密化不全具有特有的病理组织学变化,临床无特异性表现,超声心动图是临床诊断心肌致密化不全的主要辅助手段之一.
목적 탐토심기치밀화불전적림상병리특정.방법 수집5례심기치밀화불전환자적림상증상、체정、심전도급초성심동도정황,측량심장적대체정황,포괄심장적중량、종장、횡관급각판막배적장도、심실류인도화류출도적장도、심실벽적후도.상규제편,린오산소목정염색、탄력섬유염색,광경관찰심기정황급관상동맥적개변.결과 5례환자균위남성,29-57세,림상균유흉민증상,심전도현시심률실상,초성심동도검사3례진단위심기치밀화불전,병리분석가견수루심강내현시유이상조대적기소량화교착심함적은와,종심저도심첨치밀심기축점변박;심내막위증후적섬유조직,내층비치밀심기기속조대문란、세포핵기형,외층치밀심기기속주행급형태기본정상,세포핵대소균균.결론 심기치밀화불전구유특유적병리조직학변화,림상무특이성표현,초성심동도시림상진단심기치밀화불전적주요보조수단지일.
Objective To investigate the clinicopathologic manifestations of non-compaction of ventricular myocardium(NVM). Methods Clinical data, electrocardiograms, echocardiography images and pathologic changes were studied in five cases of non-compaction of ventricular myocardium. Results The patient's ages ranged from 29 to 57 years old, all were males. Abnormal electrocardiograms were obtained in all of the 5 cases. Among them, 3 were diagnosed using echocardiography. Histopathologie examination showed that there were abnormally coarse muscle trabeculation and deep recesses, interlacing in arrangement, over the inner wall of the heart chambers. The compacted myocardium became thinning down gradually from the base to the apex of the heart. The non-compacted myocardium bundles locating close to the endocardium were coarse and orderless in arrangement, nuclei were irregular and abnormal,nevertheless, the arrangement and appearance of the muscle bundles near by the pericardium part were essentially normal and the cell nuclei were evenly distributed. Conclusion There are no specific clinical manifestations obtained in patients with non-compaction of ventricular myceardium, however, the pathologic changes are characteristic and a clinical diagnosis can be made by using echocardiography.