克山病患者心脏移植术后急性排异反应的监测

目的对３例重症克山病患者同种原位心脏移植术后进行监测，探讨心脏移植术后急性排异反应的监测指标。方法监测指标：临床症状；１２导联心电图；超声心动图；单光子计算机体层扫描；外周血Ｔ淋巴细胞检查；心内膜心肌活检；Ｘ线影像。结果行ＥＭＢ１９次，发现１ｂ级和２级各１次，３ａ级２次。３ａ级时ＵＣＧ发现心包积液有增加趋势，其余指标未见明显改变。结论心内膜心肌活检是诊断急性排异反应敏感可靠的指标，其它一些常用的指标不敏感且缺乏特异性，但可做为辅助指标。

Acute rejection monitoring in patients with chronic Keshan disease after heart transplantation

Objective Three patients with severe chronic Keshan Disease were monitored in order to find proper monitoring parameters for acute rejection (AR) after heart transplantation.Methods The following techniques were used in three cases for comparison:symptoms;12 leads ECG;UCG;SPECT;peripheral blood lymphocyte test;endo myocardial biopsy(EMB);chest X ray.Results Total 19 times of EMB were performed to these patients.The myocardial pathologic changes of class 1b and class 2 were found 1 time respectively, class 3a were found 2 times.when the change of class 3a occured,the trend of increased pericardial effusion was discovered through UCG method other parameters hadn't changed significantly.Conclusions Except EMB,other techniques proved to be not as satisfactory in both speciality and sensitivity as EMB.