心肌间质脂肪浸润105例临床病理学分析  

Fatty infiltration of myocardial interstitium:clinicopathologic analyses of 105 autopsy cases

作　　者：赵颖海[1] 孙宁[1] 陈小毅[1] 李飞虹[2] 

机构地区：[1]广东医学院病理学教研室,湛江524023 [2]广东医学院形态学实验室,湛江524023

出　　处：《临床与实验病理学杂志》2010年第5期552-555,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的对比研究心肌间质脂肪浸润和致心律失常性右心室心肌病(arrhythmogenic right ventricular cardiomyopathy,ARVC)的病理学特点,探讨其发生发展的相关因素及影响。方法收集105例心肌间质有脂肪无纤维组织浸润病变和6例ARVC的尸检资料,对比二者的病变特点,分析心肌间质脂肪浸润程度与年龄、冠状动脉狭窄程度的相互关系。结果 (1)105例病变表现为心肌间质仅有脂肪组织浸润和渐进的心肌萎缩;6例ARVC特征性的病变是右心室为主的心肌层被广泛的纤维脂肪组织所替代,伴有心肌萎缩或炎细胞浸润。(2)心肌间质脂肪浸润与年龄增长和冠状动脉狭窄程度无关(P>0.05)。(3)心肌间质脂肪浸润伴心肌细胞萎缩率为57.14%(60/105),轻度组(7/42,16.67%)与中度组(39/47,82.98%)和重度组(14/16,87.50%)比较差异有统计学意义(P<0.01);中度组与重度组比较差异无统计学意义(P>0.05)。(4)14例中重度心肌间质脂肪浸润和5例ARVC均表现为心源性猝死。结论人体心肌间质脂肪浸润常常伴有心肌细胞萎缩,其发生发展与年龄增长和冠脉狭窄无关;中重度心肌间质脂肪浸润和ARVC可发生心源性猝死。Purpose To compare the pathological features of fatty infiltration in the myocardial interstitium with arrhythmogenic right ventricular cardiomyopathy（ARVC）,and to analyze its pathogenesis correlated factors and their effects.Methods 105 cases of the myocardium replacement by isolated fatty without fibrous tissue and 6 case of ARVC autopsy cases were collected.The pathological features were compared between the two processes.The correlations between fatty replacement of the myocardium and age or degree of coronary stenosis were analyzed.Results 105 cases had isolated fatty myocardial replacement and a gradual increase of myocardial atrophy was noted at pathologic examination.Pathognomonic changes of 6 ARVC were primarily the myocardium of the right ventricle replacement by extensive fibrofatty tissue accompanied with myocardial atrophy or inflammatory infiltration.The correlation between fatty infiltrative degree of myocardial interstitium and age was not significant （P0.05）.The correlation between fatty infiltrative degree of myocardial interstitium and degree of coronary stenosis was also not significant （P0.05）.The percent of myocardial atrophy in 105 cases with fatty infiltration of myocardial interstitium accounted for 57.14% （60/105）.The low degree group（7/42,16.67%） was significantly lower than the mild degree group （39/47,82.98%） and the severe degree group（14/16,87.50%）（P0.01）.The correlation between the mild degree group and the severe degree group was not significant （P0.05）.14 cases of intermediate or severe degress of myocardial interstitium infiltrated with fatty tissue and 5 cases of ARVC developed sudden cardiac death（SCD）.Conclusions Human myocardial interstitium infiltrating with fatty tissue always accompanies with myocardial atrophy,but it is not correlated with aging and coronary stenosis.Sudden cardiac death occurs in intermediate or severe cases of the myocardium replacement by isolated fatty and ARVC.

关 键 词：心肌间质脂肪浸润 致心律失常性右心室心肌病 尸体解剖 病理学 

分 类 号：R542.202.2[医药卫生—心血管疾病]