休克时的心肌病变观察

<正> 关于休克时的心肌形态变化,以往文献中虽有记载,但多系动物实验研究结果,人体材料观察较少。在克山病研究中,早就发现急重型克山病患者都有心源性休克,病理上以广泛心内膜下心肌坏死为主要改变。关于这种心肌广泛变质性改变与休克之间的因果关系,各研究者的看法尚不一致。有人考虑这种心肌广泛变质性改变并非克山病所固有,而是继发于休克的损伤;也有人认为,此类心肌病变只见于急重型病例,是本型克山病的特征性改变,考虑心肌损伤在先,是引起休克的原因。为了弄清休克时的心肌病变特点,借以说明急重型克山病心肌病变与休克之间的关系,我们对18例非克山病休克尸检材料进行了病理观察分析。

PATHOLOGIC STUDY OF MYOCARDIAL LESIONS IN SHOCK

Eighteen cases of myocardial pathologic findings in various types of shock were reported. The main findings of the hearts were subendocardial hemorrhage, myofibrillar degeneration of single or small groups of muscle fibers, and papillary muscular infarctoid necrosis. It was observed that the incidence of the myocardial necrosis was lower, and the range of the necrosis, in general, was very small. It was suggested that the hearts which were normal in the original structure and function presented some resistance against shock.The relationship between extensive degenerative myocardial lesions of acute Keshan disease and the cardiac shock was discussed. It was considered that this myocardial necrosis of Keshan disease could not only be explained by shock itself.On the basis of previously existed some myocardial lesions, shock can play a promotive and aggrevating part.