65例慢性肺原性心脏病合并其它类型心脏病的尸检病理分析

A Pathological Study on 65 Cases of Chronic Cor Pulmonale Coexisted With Heart Disease of Different Types

目的：分析慢性肺原性心脏病（肺心病）及合并其它类型心脏病的尸检率及形态学变化。方法：采用本院６５例肺心病尸检材料，对单纯肺心病５０例与肺心病合并其它类型心脏病１５例做组织学检查、形态学分析及统计学处理。结果：肺心病的病因构成为多因素。肺心病可与一种或两种其它类型心脏病同时并存（２３．１％），以冠心病并存率最高（２０．０％）。冠状动脉粥样硬化Ⅲ～Ⅳ级病变检出率２０．０％。低体重是晚期肺心病的特点之一。女性心脏增重显著大于男性，心脏重量与体重比值较单纯心脏称重更有评估意义。肺心病与其它类型心脏病并存时心室结构重塑程度重于单纯肺心病，尤以左心室为著。结论：肺心病并存其它类型心脏病时，心脏病变程度重，临床表现复杂，应防止肺心病或合并症漏诊。

Objective:To analyse the incidence and pathological change of chronic cor pulmonale coexisted with heart disease of different types. Methods:Specimens of 65 cases of cor pulmonale autopsy (50 cases of cor pulmonale,15 cases of cor pulmonale coexisted with heart disease of different types) were studied by light microscope and statistical analysis. Results:It was possible that cor pulmonale might coexist with heart disease of one or two different types (23 1%). Among them,the coexisting rate of coronary heart disease was the highest (20 0%).The prevalence of coronary atherosclerotic lesion of Ⅲ Ⅳ degree was 20 0%.One of the features of late cor pulmonale was low weight.The weight increasing of a womans heart was far heavier than a mans.It is more valuable to have the ratio of heart and body weight than simply to obtain heart weight.When cor pulmonale coexisted with the other types of heart disease,Remodling of left and right ventriculi structure was worse than cor pulmonale,especially in left ventriculus. Conclusions:While cor pulmonale coexisted with heart disease of different types,their pathologic change of the heart was worse,and the clinical symptoms were complex.Missed diagnosis of cor pulmonale or complication should be guarded against.