摘要
目的探讨心肌梗死(myocardial infarction,MI)患者窦房结(sinoatrial node,SAN)间质增生与尸检心肌梗死透壁程度的关联性。方法搜集13例MI心脏标本,记录死者年龄和死亡原因。常规肉眼检查并记录左右冠状动脉主干狭窄及MI情况,分别在冠状动脉狭窄和左心室各壁(包括前壁、侧壁、后壁、室间隔和心尖)梗死透壁程度最重处取材;SAN采用沿长轴的横切法,常规制片。HE染色后镜下观察,Masson染色分析SAN间质增生情况,苦味酸染色确定MI透壁程度。图像分析系统分析SAN间质增生和左右冠状动脉粥样硬化管腔狭窄程度。多元线性回归和Spearman秩相关进行统计学分析。结果左右冠状动脉主干粥样硬化管腔狭窄程度与SAN间质增生存在线性关系,决定系数R2=0.688(P<0.05);尸检MI评分与SAN间质增生呈正相关,rs=0.608(P<0.05)。结论左右冠状动脉粥样硬化管腔狭窄越严重,SAN间质增生越重;MI透壁程度与SAN间质增生呈同向发展。
Objective To study the correlation between interstitial hyperplasia of sinoatrial node （ SAN} and transmural extent of myocardial infarction （ MI ） by autopsy. Methods We selectedl 3 corpses who had been found MI, age and cause of death were recorded. Coronary artery atherosclerosis and MI were checked and registered. Then, the sampling was selected at the most serious stenosed or infarcted of right and left coronary artery and every wall of left ventricular, including front wall, lateral wall, back wall, interventricular septum and apex. SAN was sampled transversely. Last,the sections were preparation. HE was done to be ob- served by microscope,and Masson~ trichrome staining and Picric acid staining were done to confirm intersti- tial hyperplasia of SAN and transmural extent of myocardial infracted, respectively. It was analysed for inter- stitial hyperplasia of SAN and relatively narrow of right and left coronary artery by image analysis system. Statistical tests were gotten by multiple linear regression and spearman＇ s rank correlation. Results Left and right coronary atherosclerosis luminal stenosis had a linear relation with stromal hyperplasia of SAN （ R2 = 0. 688 ,P 〈 0.05 }. The correlation coefficient between score of the myocardial infracted detected by autopsy and SAN＇ s interstitial hyperplasia was 0.608 （ P 〈 0.05 ）, and it showed positive correlation. Conclusion Intersti- tial hyperplasia of SAN would be getting worse and worse when luminal stenosis of left and right coronary were increased induced by atherosclerosis. The development was same tropism about transmural extent of myocardial infracted detected by autopsy and SAN＇ s interstitial hyperplasia.
出处
《济宁医学院学报》
2017年第2期132-134,138,共4页
Journal of Jining Medical University
关键词
冠状动脉粥样硬化
心肌梗死
窦房结
Coronary artery atherosclerosis
Myocardial infarction
Sinoatrial node
