不同类型克山病心肌间纤维化的形态学分析

目的 揭示克山病心肌间质中胶原的类型、分布、排列与含量。方法 采用本室克山病尸检材料,应用苦味酸－天狼星红染色和偏振兴显微镜观察和图像分析技术,系统地研究了克山病心肌胶原的变化。结果 在急性克山病的瘢痕灶内,胶原排列成疏网状,Ⅲ型胶原比例增加。慢性克山病的瘢痕中,胶原排列致密,１胶原比例增中Ⅰ／Ⅲ型腾的比值增大,在心肌晨坏死区域胶原一明显高于对照组,出现间质纤维化,以慢性克山病最明显。亚急性和慢性

Morphological studies of myocardial fibrosis in different types of Keshan disease

OBJECTIVE: To clarify the localization, distribution, content and type of collagen in the myocardium of patients with Keshan disease (KD). METHODS: Picrosirium red staining, polarization microscopy and image analysis were used to study autopsy specimens from 335 KD patients. RESULTS: A loose network of collagen and a higher ratio of type III collagen were found in the myocardial scar tissues of acute KD patients. In the myocardial scar tissues from chronic KD patients, the collagen fibers were dense, the ratio of type I collagen was higher, the ratio of type I to type III is increased in chronic KD and decreased in acute KD. The amount of collagen in non-necrotic regions was significantly higher than that of the controls. CONCLUSION: The degeneration and necrosis of myocytes in KD is associated with disorders of collagen metabolism and with structural modelling of collagen.