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[伴有阻塞性和限制性通气障碍的肺部疾病中心肌重构的结构和电学特征]

[Structural and electrical characteristics of myocardial remodeling in pulmonary diseases with obstructive and restrictive ventilation disorders].

作者信息

Sobolev V A, Golovskoĭ B V

出版信息

Klin Med (Mosk). 2003;81(5):23-6.

Abstract

Myocardial changes were studied in 239 patients with different diseases of the lungs associated with obstructive (84 patients) and restrictive (155 patients) ventilation disorders and in 109 healthy subjects (control group). Structural and electrical indices of the myocardium taken at echo- and vectorcardiography in patients with chronic pulmonary diseases differed from those of healthy subjects, depended on the type and severity of the ventilation disorders. Remodeling of the myocardium in obstructive ventilation disorders is accompanied by a moderate staged enlargement of atrial cavities, right ventricle, thickening of the walls of both ventricles in enhanced electric activity of all the heart compartment. The restrictive ventilation disorders are characterized by an early significant enlargement of both atria's cavities, and of both ventricles with maximal thickening of ventricular walls. Electric activity of the heart rose maximally at the initial stage, later it lowered. Variants of myocardial remodeling in abnormal external respiration were determined by differences in compensatory heart reactions. In the obstructive type, heart remodeling had better compensatory opportunities which manifested itself at all the stages of the ventilatory disorders. In the restrictive type, effective compensatory hyperfunction of the heart was seen only at the first stage of ventilatory disorders, at later stages it weakened.

摘要

对239例患有不同肺部疾病且伴有阻塞性(84例)和限制性(155例)通气障碍的患者以及109名健康受试者(对照组)的心肌变化进行了研究。慢性肺部疾病患者通过超声心动图和向量心电图检查得出的心肌结构和电指标与健康受试者不同,这取决于通气障碍的类型和严重程度。阻塞性通气障碍时的心肌重塑表现为心房腔、右心室中度阶段性扩大,两心室壁增厚,所有心腔电活动增强。限制性通气障碍的特征是两心房腔和两心室早期明显扩大,心室壁增厚最明显。心脏电活动在初始阶段最大程度升高,随后降低。异常外呼吸时心肌重塑的类型取决于心脏代偿反应的差异。在阻塞性类型中,心脏重塑具有更好的代偿机会,这在通气障碍的所有阶段都有体现。在限制性类型中,仅在通气障碍的第一阶段可见有效的心脏代偿性高功能,在后期则减弱。

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