Rose A G, Uys C J, Losman J G, Barnard C N
Transplantation. 1978 Jul;26(1):10-3. doi: 10.1097/00007890-197807010-00004.
The reliability of endomyocardial bioptome samples in detecting cardiac rejection was assessed in 26 formalin-fixed previously transplanted hearts. Thirteen human donor hearts (mean postoperative survival 128 days) and 13 baboon donor hearts (mean survival 16.5 days) were studied. Twenty samples were taken under direct vision from the endomyocardium of each heart with an Olympus bioptome catheter. A total of 397 tissue samples was examined "blindly" histologically (177 human and 220 baboon). The bioptome samples were assigned a histological rejection score and then compared with the score accorded multiple tissue sections from the same heart. Sample scores agreed with tissue section scores as follows: humans 86% (samples showed more severe alterations in 5% and less severe in 9%) and baboons 57% (samples more severe in 40% and less severe in 3%). Only 2 false-negative samples were encountered among 285 tissue samples from hearts showing rejection. Changes of rejection were equally distributed between the left and right ventricles. Endomyocardial sampling proved an accurate means of detecting the presence of rejection. In the baboon hearts the endomyocardium tended to show more severe changes than the rest of the myocardium.
在26颗经福尔马林固定的既往移植心脏中评估了心内膜活检样本检测心脏排斥反应的可靠性。研究了13颗人类供体心脏（术后平均存活128天）和13颗狒狒供体心脏（平均存活16.5天）。使用奥林巴斯活检导管在直视下从每颗心脏的心内膜获取20个样本。总共397个组织样本进行了组织学“盲法”检查（177个来自人类，220个来自狒狒）。给活检样本分配一个组织学排斥评分，然后与同一心脏多个组织切片的评分进行比较。样本评分与组织切片评分的一致性如下：人类为86%（样本显示更严重改变的占5%，更轻改变的占9%），狒狒为57%（样本更严重的占40%，更轻的占3%）。在显示排斥反应的心脏的285个组织样本中仅遇到2个假阴性样本。排斥反应的变化在左心室和右心室之间分布均匀。心内膜采样被证明是检测排斥反应存在的一种准确方法。在狒狒心脏中，心内膜往往比心肌的其他部分显示出更严重的变化。
