Torán N, Reig J, Rovirosa M, Ruiz de Miguel M C, Lozano C
Departamento de Anatomía Patológica, Universitaria Valle de Hebrón, Barcelona.
Rev Esp Cardiol. 1995 Jan;48(1):36-41.
Pulmonary vascular disease occurs in patients with cardiac anomalies and left to right shunt as the cases of interventricular heart defects. The hemodynamic study of the structural changes and their relationship with the pathological lesions are useful to know the state of the pulmonary vessels and to establish the postsurgical patients outcome.
We analyzed the morphologic and morphometric data in 17 lung biopsies from children under three years with ventricular septal defect, focused the histologic study in grading the structural changes of the intima, media and adventitial vascular walls and the morphometric evaluation on the thickening of the media and the number of the intracinar arteries.
There are significant statistical correlation among the pulmonary pressure and the age, the vascular resistances and the age, the cocient between the pulmonary arterial pressure and the systemic pressure and the external vascular diameter, the cocient of the pulmonary and systemic fluxes and the thickening of the media and finally between the pulmonary vascular resistances and the external arterial diameter.
Our results suggest that the intracardiac repair is desirable within 6 months of life and lung biopsy should be undertaken because is the only way to determine the medial thickening and his muscular of fibrous proliferation that will clarify the post-surgical patients outcome.
肺血管疾病发生于患有心脏异常和左向右分流的患者,如室间隔缺损病例。对结构变化及其与病理病变关系的血流动力学研究,有助于了解肺血管状态并确定术后患者的预后。
我们分析了17例3岁以下室间隔缺损儿童肺活检的形态学和形态计量学数据,组织学研究重点是对血管内膜、中膜和外膜壁结构变化进行分级,形态计量学评估则针对中膜增厚和肺小叶内动脉数量。
肺压力与年龄、血管阻力与年龄、肺动脉压力与体循环压力之比与外周血管直径、肺循环与体循环血流量之比与中膜增厚,以及最终肺血管阻力与外周动脉直径之间存在显著的统计学相关性。
我们的结果表明,心脏内修复应在出生后6个月内进行,并且应进行肺活检,因为这是确定中膜增厚及其纤维性增殖的唯一方法,这将阐明术后患者的预后。