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[二尖瓣缺损中的二尖瓣。组织学与临床相关性]

[The mitral valve in mitral valve defect. Histological and clinical correlations].

作者信息

Mularek T, Grajek S, Jasiński K, Dyszkiewicz W, Ponizyński A

机构信息

I Kliniki Kardiologii, kierownik, AM w Poznaniu.

出版信息

Kardiol Pol. 1991;35(10):225-31.

PMID:1762282
Abstract

The purpose of this study was to investigate the correlation between the histologic changes in the excised mitral valves and the clinical findings in patients with mitral stenosis (with or without regurgitation). The Study group consists of 26 men and 23 women ranged in age from 24 to 56 years. The mitral valves were removed in a uniform manner by one surgeon during mitral valve replacement. The controls were 13 mitral valves removed at necropsy from patients who died of extracardiac causes. Excised valves were fixed in 5% solution of formaline. The extent of calcification was determined by radiographs. Tissue from the center of the anterior and posterior leaflet were selected as the samples. The blocks were paraffin embedded and processed in the conventional manner. For histological examination 11.5 um thick sections were stained with haematoxylin and eosin, Alcian blue, Van Gieson and Von Koss stain. Then the sections were examined under light microscope. We estimated the degree of fibrotic disorganization of architecture, vascularization, acid mucopolysaccharide content, number of fibroblasts, and the presence of calcific deposits and lymphoid infiltrates. The control valves had normal architecture with thick "fibrosa". In all stenotic mitral valves we found complete or partial disorganization of architecture. The most common change was hyalinization present in 94% valves, vascularization in 84% and calcification present in 66% of valves. In 33% of stenotic valves were present infiltrations by lymphocytes. We found a significant correlation (p less than 0.05) between the presence of lymphoid infiltrates and the duration of disease prior to surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是调查二尖瓣狭窄(伴或不伴反流)患者切除的二尖瓣组织学变化与临床发现之间的相关性。研究组包括26名男性和23名女性,年龄在24至56岁之间。二尖瓣置换手术由一名外科医生以统一方式切除二尖瓣。对照组为13个从死于心外原因的患者尸检中取出的二尖瓣。切除的瓣膜固定于5%的福尔马林溶液中。钙化程度通过X线片确定。选取前后叶中心的组织作为样本。组织块常规石蜡包埋和处理。组织学检查时,11.5μm厚的切片用苏木精和伊红、阿尔辛蓝、范吉森和冯科萨染色。然后在光学显微镜下检查切片。我们评估了结构纤维化紊乱程度、血管化程度、酸性粘多糖含量、成纤维细胞数量、钙化沉积物和淋巴浸润的存在情况。对照瓣膜结构正常,“纤维层”增厚。在所有狭窄的二尖瓣中,我们发现结构完全或部分紊乱。最常见的变化是94%的瓣膜出现玻璃样变,84%出现血管化,66%出现钙化。33%的狭窄瓣膜有淋巴细胞浸润。我们发现淋巴浸润的存在与术前病程之间存在显著相关性(p<0.05)。(摘要截短至250字)

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