Schlag G, Voigt W H, Schnells G, Glatzl A
Anaesthesist. 1977 Nov;26(11):612-22.
The ultrastructure of skeletal muscle biopsies was investigated and compared to lung biopsy material of the same patient in shock. We found almost complete conformity of ultrastructural changes in the micro-vascular system. Capillary endothelia of both tissue types react in a similar way with a more or less distinct swelling of endothelial cells and rarefaction of cell structures as well as constriction of the vascular lumina. Despite an intact structure of the capillary endothelia there is development of oedema in the perivascular areas with escape of plasma components, erythrocytes and granulocytes into the muscle interstitium. Finally, more distant tissue regions are becoming oedematous. While mainly lysosomal enzymes from the large number of infiltrating granulocytes, as well as fatty globules, are made responsible for the damage in the shock lung, the damage of the capillary region in the sceletal musculature is almost certainly caused by hypoxia. We consider muscle biopsy a suitable method to obtain a better knowledge of the microcirculatory situation and of the reaction of ultrastructures in shock.
对骨骼肌活检的超微结构进行了研究，并与同一患者休克时的肺活检材料进行了比较。我们发现微血管系统的超微结构变化几乎完全一致。两种组织类型的毛细血管内皮细胞反应相似，内皮细胞或多或少明显肿胀，细胞结构稀疏，血管腔狭窄。尽管毛细血管内皮结构完整，但血管周围区域仍出现水肿，血浆成分、红细胞和粒细胞渗入肌肉间质。最后，更远的组织区域也出现水肿。虽然大量浸润的粒细胞中的溶酶体酶以及脂肪球主要被认为是导致休克肺损伤的原因，但骨骼肌中毛细血管区域的损伤几乎肯定是由缺氧引起的。我们认为肌肉活检是一种合适的方法，有助于更好地了解休克时的微循环状况和超微结构反应。
