Yamaki S
Tohoku J Exp Med. 1982 May;137(1):33-9. doi: 10.1620/tjem.137.33.
Correlation between the grade of pulmonary arterial change and pulmonary arterial pressure was studied in 60 patients with congenital cardiac anomalies associated with pulmonary hypertension. Of the 60, 45 specimens of pulmonary arteries were obtained by autopsy and 15 by biopsy. Pulmonary arterial pressure was correlated with the products of the medial thickness and intimal lesions of small pulmonary arteries both in the autopsy and in the biopsy specimens. Also, medial thickness and intimal lesions were independently correlated to the pulmonary arterial pressure. However, the regression equation was not identical among the kinds of diseases, although significant correlation was found between the degree of intimal lesions and pulmonary arterial pressure. Medial hypertrophy was reversible after corrective surgery, but intimal lesions were irreversible except for cellular proliferation. Therefore, to determine the indication for corrective surgery, it should be emphasized that intimal change of the small pulmonary arteries should be carefully evaluated. Since the degree of intimal lesions is not accurately diagnosed from hemodynamic parameters alone, diagnosis of intimal lesions by lung biopsy is indispensable to determine the possibility of corrective surgery in the congenital heart disease with severe pulmonary hypertension.
对60例合并肺动脉高压的先天性心脏病患者的肺动脉变化程度与肺动脉压力之间的相关性进行了研究。60例患者中，45例肺动脉标本通过尸检获得，15例通过活检获得。肺动脉压力与尸检和活检标本中小肺动脉的中膜厚度和内膜病变乘积相关。此外，中膜厚度和内膜病变与肺动脉压力独立相关。然而，尽管内膜病变程度与肺动脉压力之间存在显著相关性，但不同疾病类型的回归方程并不相同。中膜肥厚在矫正手术后可逆转，但内膜病变除细胞增殖外不可逆转。因此，为确定矫正手术的指征，应强调仔细评估小肺动脉的内膜变化。由于仅从血流动力学参数无法准确诊断内膜病变程度，因此对于重度肺动脉高压的先天性心脏病患者，通过肺活检诊断内膜病变对于确定矫正手术的可能性必不可少。
