法乐四联症右室心肌超微结构定量测量与临床的对比研究

Comparison of Ultrastructural Quantitative Study on Right Ventricular Myocardium and Clinical Data in Patients with Tetralogy of Fallot

为探讨法乐四联症（Ｆ_４）右室心肌超微结构的不同表现与Ｆ_４术前各项临床检查及术后心功能的关系，作者对室间隔缺损组（Ⅰ组，１１例），儿童Ｆ_４组（Ⅱ组，１３例）和成人Ｆ_４组（Ⅲ组，１３例）进行比较，用Ｓｙｓｔａｔ计算机统计软件作多因素方差分析和Ｐｅａｒｓｏｎ相关研究。结果见Ⅱ、Ⅲ组病人的ＰＯ_２仅和核浆比有关，Ｐ_（ＲＶ）与细胞的核体密度、横径、核浆比及肥大肌细胞比率明显有关，肥大肌细胞比率与病人年龄及ＰａＯ_２明显相关。作者认为Ｆ_４病人右室心肌超微结构改变主要系右室压力增高所致，这种改变与年龄有关。

Objective: The article reports a study on the correlation between the ultrastructural quantitative analysis of right ventricular myocardium and clinical data in patients with tetralogy of Fallot (TOF). Method : 37 cases were divided into three groups:Group Ⅰ VSD(n=11)as control,Group Ⅱof pediatric TOF (n=13)and Group Ⅲ of adult TOF(n=13).Under electric microscope,the diameters of the myocardial cells were measured and a mean value was obtained. The contents of both myocardial and mesenchymal cells were determined. These parameters were compared with the clinical data of PaCO_2, hematocrit,mean pressure of the right ventricle(MPRV),size of the VSD and age of the patients,etc.by computer. The correlationship of the ultrastructural parameters and the clinical data was calculated in the same way. Result:Pearson correlation matrix shows that the size of VSD, age of patient,mean pressure of right ventricle and PaO_2 are significantly correlated with mean diameter of myocardial cells and the contents of the hypertrophic myocardial and mesenchymal cells in group Ⅱ and Ⅲ. Conclusion: The ultrastructrual changes of right ventricular myocardium in patient with TOF are mainly due to the high pressure of right ventricle and correlated with age of the patient.