Ogawa K, Ito H, Toriyama A, Yamamoto T, Yamaguchi M, Horikoshi K, Asada S
J Thorac Cardiovasc Surg. 1979 May;77(5):728-32.
Lung biopsy specimens were taken from 39 infants younger than 12 months of age with congenital heart disease and severe pulmonary hypertension (Pp/Ps greater than or equal to 0.75) accompanied by respiratory distress. The pathological change in lung specimens and clinical courses were compared. These 39 infants underwent surgical treatment of patent ductus arteriosus (PDA), seven patients; ventricular septal defect (VSD), 13 patients; and complex heart anomaly, 19 patients. The common pathological findings of the lung specimens taken from these infants were lymphoid cellular infiltration and thickening of the alveolar septum, which we have called "septitis" in the present study. In most cases pulmonary vascular obstructive change was within Grade 2 of the Health-Edwards criteria. Septitis was classified into three categories: mild, moderate, and severe. Only three of the 19 infants with severe septitis survived postoperatively, whereas 10 of the 12 infants with moderate septitis and all eight with mild septitis could be successfully weaned. The cause of septitis remains unidentified. We have found the patient's age and pulmonary hypertension to be closely related to the grade of septitis in this study. Septitis plays a much more important role than pulmonary vascular obstructive change in the prognosis of pulmonary hypertensive heart disease in early infancy.
对39名12个月以下患有先天性心脏病且伴有呼吸窘迫的重度肺动脉高压（Pp/Ps大于或等于0.75）的婴儿进行了肺活检。比较了肺标本的病理变化和临床病程。这39名婴儿接受了动脉导管未闭（PDA）手术治疗的有7例；室间隔缺损（VSD）手术治疗的有13例；复杂心脏畸形手术治疗的有19例。从这些婴儿身上获取的肺标本的常见病理表现为淋巴细胞浸润和肺泡间隔增厚，在本研究中我们将其称为“间隔炎”。在大多数情况下，肺血管阻塞性改变处于健康-爱德华兹标准的2级以内。间隔炎分为轻度、中度和重度三类。19例重度间隔炎婴儿中只有3例术后存活，而12例中度间隔炎婴儿中有10例以及所有8例轻度间隔炎婴儿均成功脱机。间隔炎的病因尚不明。在本研究中我们发现患儿年龄和肺动脉高压与间隔炎的分级密切相关。在婴儿早期肺动脉高压性心脏病的预后中，间隔炎比肺血管阻塞性改变起的作用更为重要。
