心内膜心肌活检对心内膜心肌纤维化的诊断价值Diagnostic Value of Endomyocardial Biopsy for Endomyocardial Fibrosis
尹瑞兴
摘要(Abstract):
目的评价心内膜心肌活检(EMB)对心内膜心肌纤维化(EMF)的诊断价值,以及探讨柯萨奇B组病毒(CVB)与EMF的关系。方法对18例经心血管造影(18例)、超声心动图(4例)和核磁共振(3例)检查诊断的EMF患者施行右室EMB,并用CVB3CDNA探针与8例心内膜心肌标本进行原位杂交。结果活检成功17例(94.44%)。其主要的组织病理改变有:心内膜增厚11例(64.71%),胶原纤维化14例(82.35%),玻璃样变7例(41.18%),内膜深层小血管增生10例(58.82%),心肌间质纤维化7例(41.18%),心肌细胞变性、萎缩9例(52.94%),炎细胞浸润7例(41.18%)。获得组织病理诊断13例(76.47%)。8例标本原位杂交均无阳性杂交信号。结论EMB对EMF的诊断具有重要价值,EMF的发病可能与CVB直接感染无关。
关键词(KeyWords): 心内膜心肌纤维化;活组织检查;柯萨奇病毒;原位杂交
基金项目(Foundation):
作者(Author): 尹瑞兴
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