Fischer V W, Barner H B, LaRose L S
Arch Pathol Lab Med. 1982 Jul;106(7):336-41.
Quadriceps and myocardial biopsy specimens were obtained from 24 patients undergoing elective coronary arterial bypass grafting. Patients were divided into those with chemical diabetes (CD) (with incidentally discovered elevated glucose levels when stressed), overt diabetes (OD) (who required insulin support), and euglycemic nondiabetics (ND). Specimens from the quadriceps femoris and left anterior apical segment of the heart were examined ultrastructurally, with particular attention to the evaluation of capillary basal laminar thickness, using morphometric techniques. Results indicate (1) an increased, though statistically insignificant, thickening of capillary basal laminae in the quadriceps of CD and OD patients, in contrast with statistically significant laminar thickening in the diabetic myocardium; (2) early, mild laminar thickening in quadriceps and myocardium of the asymptomatic CD group; and (3) two characteristic patterns of basal laminar contours, homogeneous and lamellated, the latter being seen prominently in the quadriceps of diabetic patients in frequent association with pericapillary edema. These findings support the concept that basal laminar thickening in the diabetic is associated with deranged carbohydrate metabolism.
从24例接受择期冠状动脉搭桥术的患者身上获取了股四头肌和心肌活检标本。患者被分为化学性糖尿病（CD）患者（应激时偶然发现血糖水平升高）、显性糖尿病（OD）患者（需要胰岛素支持）和血糖正常的非糖尿病患者（ND）。对股四头肌和心脏左前心尖段的标本进行了超微结构检查，特别注意使用形态计量学技术评估毛细血管基底膜厚度。结果表明：（1）与糖尿病心肌中具有统计学意义的基底膜增厚相比，CD和OD患者股四头肌中毛细血管基底膜增厚，虽无统计学意义，但有所增加；（2）无症状CD组的股四头肌和心肌中存在早期轻度基底膜增厚；（3）基底膜轮廓有两种特征性模式，即均匀型和层状型，后者在糖尿病患者的股四头肌中尤为明显，常伴有毛细血管周围水肿。这些发现支持了糖尿病患者基底膜增厚与碳水化合物代谢紊乱有关的观点。
