Mahaim纤维致猝死5例

寻找心源性猝死者的病理形态学诊断依据。采用本组建立的心传导系统检查法 ,对 16 5例无心外器官疾病猝死者的心脏 ,作心传导系统的组织学检查。发现 5例存在心传导系统Mahaim纤维 ,全部均为束室束型。本组Ma haim纤维的形态学与房室束 (HB)或左束支 (LBB)相似 ,胞体横径在 10～ 35 μm左右 ,胞浆丰富 ,色淡红染 ;来自HB的纤维胞体呈细条状 ,核居中 ;来源于LBB的则按其始发点不同自上而下逐渐变大 ,纵切细胞未见分叉 ,但部分细胞周围见有一薄层结缔组织包围。分析结果表明 ,Mahaim纤维是可致猝死的房室传导旁路。

Five cases of sudden cardiac death due to Presence of the Mahaim fiber

To find out some morphological features for the diagnosis of sudden cardiac deaths.The CCS from 165 cases of sudden death without extracardiac causes of death were sampled by using the method described previously.Serial sections were prepared for histological observation and immunohistochemical staining.Five cases with Mahaim's fiber were discovered.It accounted for 3% in the sudden death group;All 5 cases belongs to the bundle ventricular bundle type.The characteristics of Mahaim's fibers were found as follows:The fibers were 10～35μm in transverse diameter,usually with abundant cytoplasm,lightly stained.The bodies of the cells of the Mahaim's fiber which originate from the HB were slender,with nuclei in the middle of the cells,while the shape of cells of LBB type varies with the origin of the Mahaim's fiber,the size of cells nieveased gradually from up downward.The cells were not bifurcated,but some of the cells were surrounded by a thin layer of fibrous tissue.Mahaim's fiber is a A V by path which may lead to fatal outcome.