Haworth S G, Sauer U, Bühlmeyer K
Br Heart J. 1980 Mar;43(3):306-14. doi: 10.1136/hrt.43.3.306.
The structural effect of prostaglandin E1 on the pulmonary circulation in pulmonary atresia has been studied by applying quantitative morphometric techniques to the injected and inflated lungs of eight babies who had received prostaglandin E1 for between 30 hours and 12 days. The most striking effect was on the pulmonary arterial smooth muscle. Relative arterial medial thickness was reduced and muscle did not extend as far along the arterial pathway as compared with the normal and with untreated cases of pulmonary atresia, dying at a similar age. The reduction in muscularity tended to increase the longer the duration of infusion. In all cases the thin arterial media was less compact than normal, and localised aneurysmal dilatations occurred, varying in extent and severity between cases. The preacinar arteries were dilated in comparison with the untreated cases, but, by contrast, the intra-acinar arteries remained abnormally small. The number of intra-acinar arteries per unit area of lung was greater in prostaglandin E1 treated than in untreated cases. Infusion of prostaglandin E1 is now the ideal emergency treatment for pulmonary atresia, but the findings in the present study suggest that it should be given for as short a time as possible before the pulmonary blood flow is increased by surgical treatment.
通过对8名接受前列腺素E1治疗30小时至12天的婴儿的注射并充气的肺部应用定量形态测量技术，研究了前列腺素E1对肺动脉闭锁时肺循环的结构影响。最显著的影响是对肺动脉平滑肌。与正常情况以及在相似年龄死亡的未经治疗的肺动脉闭锁病例相比，相对动脉中层厚度减小，并且肌肉沿动脉路径延伸的距离较短。输注时间越长，肌肉减少的趋势越明显。在所有病例中，薄的动脉中层比正常情况更疏松，并且出现了局部动脉瘤样扩张，病例之间的范围和严重程度各不相同。与未经治疗的病例相比，腺泡前动脉扩张，但相比之下，腺泡内动脉仍然异常细小。每单位肺面积的腺泡内动脉数量在接受前列腺素E1治疗的病例中比未治疗的病例更多。目前，输注前列腺素E1是肺动脉闭锁的理想紧急治疗方法，但本研究结果表明，在通过手术治疗增加肺血流量之前，应尽可能短时间地给予该药物。
