【摘要】 目的探讨心脏传导系统(CCS)病变与心律失常及心电图ST-T改变的关系。方法对12例有临床心电图异常改变的心脏标本作CCS组织学观察。结果(1)12例心电图异常者均见CCS有病变,包括有CCS脂肪浸润和(或)纤维化、淀粉样变、炎症、发育异常及出血等。(2)组织学显示急性炎症性改变者的心电图改变主要有:窦性心动过速、频发多源性室性早搏。(3)组织学显示慢性退行性改变者的心电图改变复杂多样:包括慢-快综合征、窦性心动过缓并室内分支传导阻滞、房室传导阻滞及心室内传导阻滞。(4)CCS病变可有心电图ST-T改变。结论CCS病变是心律失常及心电图ST-T改变的病理基础之一。更多还原

【Abstract】 Objective To investigate the relationship between abnormal ECG and pathologic changes in the cardiac conduction system (CCS). Method Pathological changes of the CCS in 12 cases with abnormal ECG out of 16 pre-death ECG were observed. Results (1) Among 7 cases of sudden cardiac death, ECG monitoring recorded bradyarrhythmia in 6 cases, tachyarrhythmia 6 cases, bradycardia-tachycardia syndrome 2 cases, conduction block 6 cases, atrial premature beats 6 cases, ventricular premature beats 6 cases, and ST-T changes 4 cases. (2) The histopathological findings in the CCS were noted in all cases. Of these 12 cases, three had signs of fatty infiltration, and/or fibrous 4 cases, three of amyloidosis, one of chronic inflammatory changes, two of acute inflammatory changes, two of developmental anomalies, two of hemorrhages and one of LAD stenosis. (3) Acute inflammation changes in the CCS corresponded to tachyarrhythmia and multiple ventricular premature beats, whereas chronic inflammation and degenerative changes in the CCS were often related to bradyarrhythmia, bradycardia-tachycardia syndrome and conduction block. (4) The CCS changes alone could lead to ST-T changes in ECG. Conclusion The pathological changes in the CCS are related to ECG changes, and attributed to the pathological bases of arrhythmia.更多还原