【摘要】 目的 :研究扩张性心肌病的病变特点 ,探索病变发生发展的机理。方法 :利用BATISTA手术方法切取 8例扩张性心肌病患者左室心肌 ,进行大体、光镜及超微结构的形态学观察。结果 :扩张性心肌病从大体上可分为室壁增厚及脂肪浸润两种类型。室壁增厚型的病变除如常规报道外 ,发现心肌间微小血管内皮细胞肿胀 ,管腔普遍狭窄 ,甚至闭塞。电镜证实是因内皮细胞中有大量 10 0nm大小的均质分泌颗粒所致。与之毗邻的损伤心肌细胞内亦有完全相同的分泌颗粒。结论 :从形态学推测此种分泌颗粒来源于损伤的心肌细胞 ,进入邻近的内皮细胞后 ,加重了心肌缺血 ,此恶性循环可能导致扩张性心肌病不断恶化进展更多还原

【Abstract】 AIM: To study the pathological features of the dilated cardiomyopathy and the mechanisms involved. METHODS: The left ventricular myocardium specimens were obtained from 8 patients with dilated cardiomyopathy by BATISTA. The morphological changes was examined macropathologically and histopathologically. RESULTS: The dilated cardiomyopathy from 8 patients can be classified into two types macropathology. One of them showed hypertrophy of left ventricular wall and the other showed fatty infiltration on myocardium of the left ventricular. In the first type, swelling of the endothelial cells as well as luminal stenosis even occlusive of small arteries and arterioles were observed in the study. Electronical microscopical examination showed that there were a lot of homogeneous secretory granules in the endothelial cells. CONCLUSION: These results suggested that the secretory granules might be from the damaged myocardial cells and entered into the adjacent endothelial cells. The pathological changes mentioned above could aggravate the ischemia of myocardium. At the same time, the vicious cycle make the pathological changes more serious. Further study should be made to confirm the nature of the secretory granules.更多还原