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心绞痛发作后6小时内死亡的90(男75、女15)例患者(年龄34～69岁),在发病前2周内生活正常且未就诊,或者原有稳定型心绞痛如常.按病史分为未知和已知有缺血性心脏病(稳定型心绞痛和/或陈旧性心肌梗塞)各45例,且年龄、性别相似.尸体心脏以加热的硫酸钡悬液灌注冠状动脉造影.然后心外膜冠状动脉全长切成每段长3mm的标本,镜检:狭窄程度,粥样斑块出现裂隙,附壁的或闭塞性血栓.在室间隔中段水平横截心室,切取1cm厚肌片,依次分割成小块.先作HE染色,筛选小血管闭塞的肌块;然后按改良三色法染色,即可识别管腔内容物:血小板紫红色,纤维蛋白红色,红细胞黄色.由血小板(及纤维蛋白)组成的直径>50μm的团块才算血小板栓子.低倍镜检室壁各层的心肌坏死灶及其分布.27例(27/90)患者的心肌小血管内发现血小板凝块.血管闭塞和未闭塞者血小板凝块出现率(8/31对19/59)无明显差别.
Ninety (75 males, 15 females) patients (age range, 34-69 years) who died within 6 hours after angina pectoris had normal or no medical attention within 2 weeks prior to the onset of disease or were classified as having stable angina Unknown and known 45 cases of ischemic heart disease (stable angina and / or old myocardial infarction) and age and gender similar to the body of the heart with heated barium sulfate suspension perfusion coronary angiography and then the epicardium Coronary cut into 3mm length of each specimen, microscopic examination: the degree of stenosis, atherosclerotic plaque appeared fissures, or parietal or occlusive thrombosis in the middle of the interventricular septum horizontal horizontal ventricle, cut 1cm thick sheet, followed by Divided into small pieces. First for HE staining, screening of small vessel occlusion of the muscle mass; and then by improved tri-color staining to identify the lumen contents: platelet purple, fibrin red, red blood cells yellow by platelets (and fibers Protein) were counted as thrombocytopenia with a diameter of> 50 μm, myocardial necrosis and its distribution in each layer of low magnification microscopy, and platelet clots were found in the myocardium of 27 patients (27/90). The incidence of thrombocytopenia in patients with and without occlusion (8/31 vs 19/59) was unknown Difference.