Löser H, Themann H, Welim W, Dittrich H
Klinik für Kinderkardiologie, Universität Münster.
Dtsch Med Wochenschr. 1988 Oct 21;113(42):1630-4. doi: 10.1055/s-2008-1067861.
Three cases of congenital alcoholic cardiomyopathy and cardiac defects in children are described. The mothers were heavy spirits drinkers. One child had a ventricular septal defect, two had Fallot's tetralogy, all requiring operation. At open-heart surgery left-ventricular myocardial biopsies were obtained in all three children. Histological and electronmicroscopic examination revealed primary toxic and hypotrophic changes, which differed from those seen in alcoholic cardiomyopathy of the adult. The cells, their nuclei and the myofibrils had reduced diameters. The mitochondria were damaged to differing extent. The myofibrils were arranged in parallel and some had contraction bands and ruptures. The sarcoplasmic reticulum was dilated and had vacuoles. The cell surface penetrated into the interstitial tissue. All these changes could have resulted from inhibited embryofetal cell growth and cytotoxic damage by alcohol during pregnancy. It would seem that alcoholic cardiomyopathy occurs only in extreme forms of alcohol abuse during pregnancy. The prognosis is as yet unknown.
本文描述了3例儿童先天性酒精性心肌病及心脏缺陷病例。患儿母亲均为酗酒者。1例患儿患有室间隔缺损，2例患有法洛四联症，均需手术治疗。在心脏直视手术中，对所有3例患儿均进行了左心室心肌活检。组织学和电子显微镜检查显示出原发性毒性和营养障碍性改变，这与成人酒精性心肌病所见不同。细胞、细胞核及肌原纤维直径均减小。线粒体有不同程度的损伤。肌原纤维平行排列，部分出现收缩带和断裂。肌浆网扩张并有空泡形成。细胞表面侵入间质组织。所有这些改变可能是由于孕期酒精抑制胚胎细胞生长及细胞毒性损伤所致。看来酒精性心肌病仅发生于孕期极端酗酒的情况。目前预后尚不清楚。
