Wagenvoort C A
Schweiz Med Wochenschr. 1985 Sep 28;115(39):1319-22.
In dealing with pulmonary vascular disease, essential for the clinician are its correlation with pulmonary arterial pressure and resistance, its potential reversibility and its prognosis for the patient. These relations, however, are far from simple. Medial hypertrophy as well as intimal fibrosis have a fairly good correlation with pressure and resistance in plexogenic arteriopathy but not in pulmonary venous hypertension. Reversibility of intimal fibrosis, and thereby its prognosis for the patient, depends not only on its severity but particularly on its type. The concentric-laminar form of intimal fibrosis for instance has an ominous prognosis when severe in contrast to other types. Not only the various forms of vascular changes and their severity but also the type of pulmonary hypertensive disease have to be taken into account for an accurate evaluation of a lung biopsy.
在处理肺血管疾病时,临床医生必须了解其与肺动脉压力和阻力的相关性、潜在的可逆性以及对患者的预后。然而,这些关系远非简单。在致丛性动脉病中,中层肥厚以及内膜纤维化与压力和阻力有较好的相关性,但在肺静脉高压中并非如此。内膜纤维化的可逆性及其对患者的预后不仅取决于其严重程度,尤其取决于其类型。例如,内膜纤维化的同心层状形式在严重时预后不良,与其他类型形成对比。为了准确评估肺活检,不仅要考虑各种形式的血管变化及其严重程度,还要考虑肺动脉高压疾病的类型。