Haworth S G, Sauer U, Bũhlmeyer K, Reid L
Am J Cardiol. 1977 Nov;40(5):781-8. doi: 10.1016/0002-9149(77)90197-7.
The application of quantitative morphometric techniques to evaluation of the lungs of nine children who died with a ventricular septal defect between the ages of 3 months and 4 years showed that the presence of pulmonary hypertension interferes with the growth and development of the pulmonary circulation. In all cases the preacinar arteries were of normal size and not dilated, and arterial size and number within the acinus were reduced and similar to those seen in the normal child at birth. Arterial and venous muscularity was increased as judged by an increase in wall thickness and by the presence of muscle in smaller and more peripheral arteries than is normal. Elevation of resistance was associated with failure of the intraacinar pulmonary circulation to develop normally rather than to obliterative pulmonary vascular disease. In view of the rapidity with which impairment of growth and elevation of resistance can develop, closure of a large defect is recommended before age 2 years.
应用定量形态测量技术对9名年龄在3个月至4岁之间死于室间隔缺损的儿童的肺部进行评估，结果显示肺动脉高压的存在会干扰肺循环的生长和发育。在所有病例中，腺泡前动脉大小正常且未扩张，腺泡内动脉的大小和数量减少，与正常新生儿相似。通过壁厚增加以及在比正常情况更小且更外周的动脉中存在肌肉判断，动静脉肌层增厚。阻力升高与腺泡内肺循环未能正常发育有关，而非与闭塞性肺血管疾病有关。鉴于生长受损和阻力升高可能迅速发展，建议在2岁前闭合大型缺损。
