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目的:研究犬急性心房颤动时心房内皮细胞超微结构的变化,探讨房颤左房血栓形成的可能机制。方法:取16只健康成年杂种犬,随机均分为空白对照组(仅接受开胸手术而不起博)和快速心房起搏(RAP)组(建立急性房颤模型)。分别取两组犬的左心耳、右心耳部位心肌组织,进行苏木素伊红(HE)染色,在普通光镜下观察心肌细胞形态学改变;在电镜下观察心耳内皮细胞形态学改变。结果:(1)RAP组所有犬均成功诱发出阵发性房颤;(2)普通光镜下两组的心耳、心内膜组织在形态学上无显著差异;(3)透射电镜下,RAP组心耳组织内皮细胞呈现不同程度的不完整,部分脱落,而空白对照组内皮细胞层完整,未见坏死、脱落,与空白对照组比较,RAP组内皮细胞不完整性(12.5%比75.0%)显著增加(P=0.041)。结论:急性房颤时内皮细胞的超微结构已经发生改变,这可能与房颤时附壁血栓形成有关。
Objective: To study the changes of atrial endothelial cell ultrastructure in dogs with acute atrial fibrillation and to explore the possible mechanism of left atrial thrombosis in atrial fibrillation. Methods: Sixteen healthy adult dogs were randomly divided into blank control group (thoracotomy only) and rapid atrial pacing (RAP) group (acute atrial fibrillation model). The left atrial appendage and the right atrial appendage of myocardial tissue of two dogs were stained with hematoxylin and eosin (HE). The morphological changes of myocardial cells were observed under ordinary light microscope. Morphological changes of auricular endothelial cells were observed under electron microscope. Results: (1) Paroxysmal atrial fibrillation was successfully induced in all dogs in RAP group. (2) Morphology of atrial appendage and endocardium in normal dogs was not significantly different. (3) Under transmission electron microscope, RAP Endothelial cells in the atrial appendage group showed incomplete and partial exfoliation in some degree, while the endothelial cell layer in the blank control group was intact without necrosis and shedding. Compared with the blank control group, endothelial cell integrity in the RAP group (12.5% vs. 75.0% Significantly increased (P = 0.041). Conclusion: The ultrastructure of endothelial cells has changed during acute atrial fibrillation, which may be related to the mural thrombosis during atrial fibrillation.