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目的 探讨风湿性二尖瓣病变患者右心房心肌超微结构改变与肺组织的病理变化(光学显微结构和超微结构)之间的相互关系。 方法 24例患者均在建立体外循环前取右心耳心肌和肺组织经超薄切片后用透射电子显微镜观察,肺组织同时制作石蜡片用光学显微镜观察。 结果 右心房心肌的病变程度与肺组织的病变程度基本一致;肺光学显微镜下级、级病变者心肌和肺组织超微结构改变较级、级者有加重的趋势,增厚的气血屏障基底膜中可见成纤维细胞插入。 结论 右心房心肌肌丝广泛性溶解在一定程度上更能反映患者的病情;肺毛细血管基底膜和肺间质的改变较突出;成纤维细胞的迁移、转化可能与肺血管壁增厚有关
Objective To investigate the relationship between ultrastructural changes of right atrial myocardium and pathological changes of lung tissue (optical microstructure and ultrastructure) in patients with rheumatic mitral valve disease. Methods Twenty-four patients were examined by transmission electron microscopy after ultrathin sections of the right atrial appendage myocardium and lung tissue were established before cardiopulmonary bypass. Paraffin slices of lung tissue were observed under light microscope. Results The degree of lesion in the right atrium myocardium was basically the same as that in the lung tissue. The ultrastructural changes in the myocardium and lung tissue of the lower and the grade lesion in the lung optical microscope were more serious than those in the lung tissue. The thicker blood-base barrier basement membrane In the visible fibroblasts inserted. Conclusion The extensive dissolution of myofilament in the right atrium can reflect the patient’s condition to a certain extent. The changes of pulmonary capillary basement membrane and pulmonary interstitium are prominent. The migration and transformation of fibroblasts may be related to the thickening of pulmonary vascular wall