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本文报告了20例小儿克山病尸检例心肌改变的光学与电镜的定位观察。亚急型克山病急性损伤区的心肌凝固性坏死是由于肌丝的过度收缩和透明变性,心肌线粒体异位和钙化的结果。广泛空泡变性区多为肿胀、退化和囊泡化的线粒体,同时肌丝逐渐溶解,消失。在光学显徵镜下慢型克山病心肌的基本改变主要是修复、治愈和瘢痕形成及不同程度心肌肥大,远离斑痕灶部位的电镜所见为肌原纤维粗细不等,排列不规则,少数肌原纤维离散、断裂,线粒体数目明显增多,作者也讨论了心肌结构改交与功能的关系及其心肌病变的发生机理。
This article reports the optical and electron microscopic localization of myocardial changes in 20 children with Keshan disease. Subacute KK disease acute myocardial necrosis is due to myofilament over-contraction and transparent degeneration, myocardial mitochondrial ectopic and calcification results. Widely vacuolar degeneration area mostly swollen, degenerated and vesicular mitochondria, while the filament gradually dissolved, disappear. Under the optical microscope, the basic changes of chronic Keshan disease myocardium are mainly repair, cure and scar formation and myocardial hypertrophy in different degrees. Electron microscopy away from the site of the stain marks is myofibrillar thickness ranging from irregular, Myofibrils are discrete, ruptured, the number of mitochondria increased significantly, the author also discussed the relationship between the switch to the function of myocardial structure and the pathogenesis of cardiomyopathy.