室间隔缺损合并肺动脉高压的肺血管结构重建特点

Characterization of pulmonary vascular structural remodelling of ventricular septal defect with pulmonary hypertension

目的探讨空间隔缺损合并肺动脉高压的肺血管结构重建，分析肺血管结构重建与血流动力学指标之间的关系。方法电镜观察肺血管超微结构变化，测定肺小动脉中层厚度百分比（ＰＭＴ）。结果肺血管改变为Ｈｅａｔｈ＆ＥｄｗａｒｄｓⅢ级组与Ⅰ级组之间ＰＭＴ差异有非常显著意义（Ｐ＜０．０１），＞Ⅲ级组与Ⅰ级组之间ＰＭＴ差异有显著意义（Ｐ＜０．０５），而在其他组别之间，差异无显著意义（Ｐ＞０．０５）。结论室间隔缺损合并肺动脉高压片血管结构重建过程中，肺血管的改变以肺小动脉的中层变化为主，肺血管内皮细胞在促进和抑制平滑肌细胞生长中，具有调控其平衡生长的作用。

Objective To study the remodelling significance of pulmonary vascular structure in ventriclar septal defect with pulmonary hypertension and to analyse the correlation between pulmonary vascular change and hemodynamic indices.Meth- ods Ultrastructural change of pulmonary vessels was observed under electronic microscope. Medial thickness of small pulmonry vessels were measured and the percentage medial thickness (PMT) calculated. Results There were significant diference in PMT between grade Ⅰ and grade Ⅲ groups (p<0.01), or groups above grade Ⅲ (P<0.05), but no significant diference between other groups (P > 0.05) was found. Conclusion Pulmonary vascular structural remodelling mainly mainly in the medium of small pulmonary vessels in patients with pulmonary hypertension. Vascular endothelial cells in those vessels may play an important role in regulating the balance between promoting and inhibiting the growth of medial smooth muscle cells.