Marboe C C, Knowles D M, Weiss M B, Fenoglio J J
Hum Pathol. 1985 Apr;16(4):332-8. doi: 10.1016/s0046-8177(85)80227-6.
A 17-year-old woman with rheumatic carditis underwent endomyocardial biopsy both prior to and following treatment with prednisone and aspirin. Frozen sections from the endomyocardial biopsy specimens were studied with monoclonal antibodies by an indirect immunofluorescence technique to define the composition of the inflammatory infiltrate in the myocardium and to determine whether the composition of the infiltrate is distinctive and diagnostically useful. The specimen from the initial biopsy contained a heterogeneous infiltrate composed of T lymphocytes, macrophages, B lymphocytes, and mast cells. T lymphocytes predominated, and the ratio of T-helper to T-cytotoxic/suppressor cells was 2.0. Following treatment the overall cellularity of the infiltrate was diminished, but the infiltrate remained heterogeneous; T cells predominated, and the T-helper to T-cytotoxic/suppressor ratio was reversed, to 0.59. The composition of the inflammatory infiltrate in this case of rheumatic carditis distinguishes it immunologically from other "idiopathic," presumably virus-associated, forms of myocarditis.
一名患有风湿性心肌炎的17岁女性在接受泼尼松和阿司匹林治疗之前和之后均接受了心内膜心肌活检。通过间接免疫荧光技术，使用单克隆抗体对心内膜心肌活检标本的冰冻切片进行研究，以确定心肌中炎性浸润的组成，并确定浸润的组成是否具有独特性且对诊断有用。初次活检的标本含有由T淋巴细胞、巨噬细胞、B淋巴细胞和肥大细胞组成的异质性浸润。T淋巴细胞占主导，辅助性T细胞与细胞毒性/抑制性T细胞的比例为2.0。治疗后，浸润的总体细胞数量减少，但浸润仍为异质性；T细胞占主导，辅助性T细胞与细胞毒性/抑制性T细胞的比例反转，变为0.59。该例风湿性心肌炎的炎性浸润组成在免疫学上使其与其他“特发性”（可能与病毒相关）形式的心肌炎区分开来。
