ASSOCIATION OF EOSINOPHILS WITH CARDIAC RUPTURE
ASSOCIATION OF EOSINOPHILS WITH CARDIAC RUPTURE
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DOI：
10.1016/s0046-8177(85)80105-2
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发表时间：
1985-01-01
期刊：
影响因子：
3.3
通讯作者：
VIRMANI, R
中科院分区：
文献类型：
--
作者：
ATKINSON, JB;ROBINOWITZ, M;VIRMANI, R
10%死于急性心肌梗死的患者发生心脏破裂，但其发病机制尚不清楚。随机选择的20例心脏破裂患者在尸检时进行回顾性回顾，并将结果与20例年龄和性别匹配的死于急性跨壁心肌梗死而未破裂的对照组进行比较。两组患者从胸痛发作到死亡的时间相似(5.7 .+-。破裂患者为5.8天，而破裂患者为4.2天。（对照组为4.9天），在全身性高血压、糖尿病、高胆固醇血症、心肌梗死史或心绞痛的发生率方面没有差异。两组患者冠状动脉粥样硬化的严重程度不同，55%的心脏破裂患者有单支血管病变，70%的无心脏破裂患者有3支血管病变。心脏破裂患者血栓的发生率高于无心脏破裂患者。在10个高倍镜下定量观察每位患者的炎症细胞反应（白细胞数量和类型）。心脏破裂患者的炎症反应更大。与心脏破裂相关的心脏炎症反应中嗜酸性粒细胞的数量显著增加（P < 0.01）(29.5 .+-。4%)高于对照组(11.7% +-。3.1%)。嗜酸性粒细胞富含芳基硫酸酯酶B、过氧化物酶、葡萄糖醛酸酶、β。-甘油磷酸酶、主要碱性蛋白和亲酸性阳离子蛋白可进一步削弱坏死心肌，并在一定程度上决定急性心肌梗死最终是否会导致心脏破裂。
Cardiac rupture occurs in 10% of patients who die with acute myocardial infarction, but the pathogenesis remains unclear. Randomly selected patients (20) with cardiac rupture were reviewed retrospectively at autopsy, and the findings were compared with those of 20 age- and sex-matched control subjects who had died of acute transmural myocardial infarction without rupture. The times from the onset of chest pain to death were similar in the 2 groups (5.7 .+-. 5.8 days for patients with rupture vs. 4.2 .+-. 4.9 days for control subjects), and there were no differences in the incidences of systemic hypertension, diabetes mellitus, hypercholesterolemia, history of myocardial infarction, or angina pectoris. The severity of coronary atherosclerosis was different in the 2 groups, with 55% of the patients with cardiac rupture having single-vessel disease and 70% of the patients without cardiac rupture having disease in 3 vessels. The incidence of thrombosis was greater in patients with cardiac rupture than in those without. The inflammatory cell response in each patient was quantitated microscopically (number and type of leukocytes) in 10 high-power fields. The inflammatory response was greater in patients with cardiac rupture. The number of eosinophils in the inflammatory response was significantly (P < 0.01) greater in hearts associated with cardiac rupture (29.5 .+-. 4%) than in control hearts (11.7 .+-. 3.1%). Eosinophils rich in arylsulfatase B, peroxidase, glucuronidase, .beta.-glycerophosphatase, major basic protein and eosinophilic cationic protein may further weaken the necrotic myocardium and, in part, determine whether acute myocardial infarction will eventually result in cardiac rupture.