Unverferth D V, Magorien R D, Unverferth B P, Talley R L, Balcerzak S P, Baba N
Cancer Treat Rep. 1981 Nov-Dec;65(11-12):1093-7.
The purpose of this study was to document early structural changes in the human heart after the initial administration of doxorubicin. Endomyocardial biopsies were performed at baseline and at 4 and 24 hours after doxorubicin administration to 13 patients. Morphometric analysis of electron micrographs (x 31,200) quantitated mitochondrial and tubular sizes (sarcoplasmic reticulum and T tubules). The mitochondrial size increased from 0.25 +/- 0.01 mu 2 (mean +/- SE) at baseline to 0.27 +/- 0.03 mu 2 (not significant [NS]) at 4 hours and 0.30 +/- 0.03 mu 2 (NS) at 24 hours. The tubular size increased from 2.24 +/- 0.13 x 10(4) nm2 at baseline to 2.60 +/- 0.26 x 10(4) nm2 (P less than 0.05) at 4 hours and 2.46 +/- 0.29 x 10(4) nm2 (NS) at 24 hours. Micrographs analyzed for nuclear changes showed nucleolar contraction and segregation of granular and fibrillar components. These changes were noted in five of ten patients at 4 hours and in eight of 13 patients at 24 hours. Serial echocardiographic and systolic time interval determinations of left ventricular function demonstrated a significant improvement at both 4 and 24 hours. In conclusion, doxorubicin has its most significant effect on tubular structures. Left ventricular function improved during this time despite these findings.
本研究的目的是记录初次给予阿霉素后人类心脏的早期结构变化。对13例患者在基线时以及给予阿霉素后4小时和24小时进行心内膜心肌活检。对电子显微镜照片（放大31,200倍）进行形态计量分析，以量化线粒体和管状结构（肌浆网和T小管）的大小。线粒体大小从基线时的0.25±0.01μm²（平均值±标准误）增加到4小时时的0.27±0.03μm²（无显著性差异[NS]），24小时时为0.30±0.03μm²（NS）。管状结构大小从基线时的2.24±0.13×10⁴nm²增加到4小时时的2.60±0.26×10⁴nm²（P<0.05），24小时时为2.46±0.29×10⁴nm²（NS）。分析核变化的显微镜照片显示核仁收缩以及颗粒和纤维成分的分离。这些变化在4小时时10例患者中的5例以及24小时时13例患者中的8例中被观察到。对左心室功能进行系列超声心动图和收缩期时间间期测定显示在4小时和24小时时均有显著改善。总之，阿霉素对管状结构有最显著的影响。尽管有这些发现，但在此期间左心室功能仍有所改善。
