摘要
目的探讨风心病持续性AF患者右房AF的病理基础。方法选择29例风湿性二尖瓣置换术患者,根据有无持续性心房颤动分为心房颤动组(AF组)和窦律组(SR组),两组之间临床因素没有统计学差异。换瓣术中取右心耳心肌标本,进行电镜定性和定量研究。结果(1)AF组线粒体体积缩小,嵴断裂、溶解较SR组显著;定量研究发现,AF组及SR组的体密度、比表面、平均截面积、平均周长分别为:177.41±48.45(10-3),100.02±14.93(10-4/nm),195737.74±56421.56(nm2)及1807.52±247.04(nm)Vs256.06±53.17(10-3),85.16±15.21(10-4/nm),280188.67±27993.79(nm2)及Vs2257.82±431.92(nm),两组之间以上指标存在显著性差异。而两组患者的面密度和面数密度没有显著性差异。(2)AF组肌原纤维的体密度为36.1±10.66%,SR组为43.72±8.9%(P<0.05),显示AF有明显的肌原纤维溶解。(3)AF组存在闰盘分离,闰盘缝隙中出现分泌物。结论风心病慢性AF与窦性心律患者,右房肌细胞病理结构之间存在显著差异。显示这些改变是导致风心病患者右房AF的重要病理基础。
Objectives To study the pathological basis of right atrial fibrillation in patients with rheumatic heart disease（RHD） with AF. Methods Twenty - nine patients with mitral valve replacement of RHD were divided into AF group（ n = 13） and sinus rhythm（SR） group（ n = 16） according to chronic AF or not. There aren t significant statistical difference in clinical factors between two groups. During the operation of valve replacement, the samples of right atrial appendages were taken and the qualitative and quantitative study were made by electron microscopy. Results （ 1 ） Mitochondrial crosta broken and dissolved could be found obviously in AF group. The mitochondrial volume in AF group is smaller than in SR group. It was shown by quantitative study that Volume density, specific surface, average area and average perimeter in AF group and SR group were 177.41± 48.45（10^-3）, 100.02 ±14.93（10^-4/nm）, 195737.74 ±56421.56 （nm^2） and 1807.52 ±247.04（nm） Vs 256.06 ±53.17（10^-3） , Vs 85.16 ± 15.21（10^-4/nm） , Vs 280188.67 ±27993.79（nm^2） and Vs 2257.82 ± 431.92 （nm） , respectively. There were significant difference of above factors between two groups. There were not significant difference of surface density and numerical density on area in the two groups. （2） Volume density of myofibril in AF group and SR group were 36.1 ± 10.66% Vs 43.72 ± 8.9% （ P 〈 0.05 ） , respectively. （ 3 ） Split of Intercalated disc（ID） gap was found in AF group,and there were marrowing and floccular substance in ID gap. Conclusions There were significant difference in the pathological change of right atrial myocardium between AF and SR with RHD. This study indicated that these changes should be the important pathological basis of RA fibrillation of AF patients with RHD.
出处
《医学研究杂志》
2006年第9期10-13,共4页
Journal of Medical Research
关键词
心脏
心房颤动
风湿性心脏病
病理学
超微结构
Heart
Rheumatic heart disease
Atrial fibrillation
Pathology
Ultrastructure
