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目的 观察法乐四联症(TOF)病人心肌细胞的形态学变化。方法 TOF手术病儿体外循环后,灌注心脏停跳液前取右室流出道组织块进行酶解,得到单个细胞。观察0.4~5 a小儿组12例,共测定103个细胞;6~11 a儿童组10例共测定101个细胞。结果 细胞长度(μm)小儿组为74.3±2.0,儿童组为85.9±2.4,细胞宽度(μm)分别为6.3±0.7,22.4±0.8,细胞长/宽比两组分别为4.9±0.2,4.0±0.2,细胞横截面积(μm2)两组分别为226.0±18.5,413.6±30.0。与小儿组相比,儿童组细胞明显延长,直径变宽,横截面积增大(P<0.001),细胞长/宽比明显减小(P<0.001)。结论 TOF右室流出道细胞形态发生明显改变,直径变宽,横截面积增大,但长/宽比却变小,这种变化导致右室肥厚程度随年龄增长而加重。
Objective To observe the morphological changes of cardiomyocytes in patients with tetralogy of Fallot (TOF). Methods After TOF surgery, the infants’ right ventricular outflow tract tissue blocks were taken out before cardiopulmonary bypass, and single cells were obtained. A total of 103 cells were detected in 0.4 to 5 years in children and 10 in children aged 6 to 11 years. A total of 101 cells were detected. Results The cell length (μm) was 74.3 ± 2.0 in pediatric group, 85.9 ± 2.4 in pediatric group, 6.3 ± 0.7 and 22.4 ± 0.8 in cell group, and 4.9 ± 0.2 and 4.0 ± 0.2 in long / 0.2, cell cross-sectional area (μm2) were 226.0 ± 18.5 and 413.6 ± 30.0 in both groups. Compared with the pediatric group, the cells in the child group were significantly prolonged, the diameter was broadened, the cross-sectional area was increased (P <0.001), and the cell length / width ratio was significantly reduced (P <0.001). Conclusions The morphology of TOF right ventricular outflow tract changes obviously. The diameter of the right ventricular outflow tract changes obviously. The diameter and cross section area of TOF are increased, but the length / width ratio is smaller. This change causes the degree of right ventricular hypertrophy aggravated with age.