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成骨不全与主动脉瓣关闭不全。1例病理结果。文献复习(作者译)

[Osteogenesis imperfecta and aortic incompetence. One case with pathological findings. Review of the literature (author's transl)].

作者信息

Acar J, Breil B, Lavabre J, Chomette G, Roland J, Dewilde J, Hospitel S

出版信息

Ann Med Interne (Paris). 1980;131(8):514-8.

PMID:7224462
Abstract

Cardiovascular manifestations of Lobstein's disease are rare, probably unrecognized, and determining factors for the final prognosis, the most frequent lesion being aortic incompetence. The eleventh case to be reported with pathological findings in the literature is described. This complication is usually found in men, blood regurgitation being large in amount, symptomatic, and progressive. Its mechanism is related less to dilatation of the aorta and its ring than to valvular changes, they being frequently bicuspid and dysplasic. Histological findings, not however pathognomonic, are myxoid degeneration in the valves and parietal cystic necrosis in the aortic wall. Apart from the absence of an aneurysm and aortic dissection, macro- and microscopic lesions are similar to those observed in Marfan's syndrome and osteogenesis imperfecta. Operative therapy was employed in all eleven cases, with three postoperative deaths and three later deaths. Certain complications arise from uncontrollable severe hemorrhage, which justifies the use of valve heterografts not requiring antivitamin K administration.

摘要

洛布斯坦病的心血管表现罕见,可能未被认识到,是最终预后的决定因素,最常见的病变是主动脉瓣关闭不全。本文描述了文献中报道的第11例有病理发现的病例。这种并发症通常见于男性,血液反流量大,有症状且呈进行性。其机制与主动脉及其环的扩张关系较小,而与瓣膜改变关系较大,瓣膜常为二叶式且发育异常。组织学发现虽无特异性,但表现为瓣膜黏液样变性和主动脉壁壁层囊性坏死。除无动脉瘤和主动脉夹层外,大体和微观病变与马方综合征和成骨不全中观察到的病变相似。11例均采用手术治疗,术后死亡3例,后期死亡3例。某些并发症源于无法控制的严重出血,这证明使用无需给予抗维生素K的异种瓣膜是合理的。

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