肺活检在先天性心脏病合并肺动脉高压的外科临床应用

ANALYSIS OF LUNG BIOPSY IN SURGERY OF CONGENITAL HEART DEFECTS WITH SECONDARY PULMONARY HYPERTENSION

先天性心脏病合并肺动脉高压的外科疗效众说纷纭,作者就肺活检定量与定性分析肺血管病变进行比较。在研究组30例先心病并肺高压与对照组11例的重复分析结果表明;“移行段”肺小动脉壁中层厚度定量分析比Heath-Edwards定性分析优越,与临床手术疗效相关性好,可重复性高、与肺动脉及动脉收缩压之比等的血流动力学指标相关性好。作者推荐经电脑分析的以心导管指标反映定量活检的方程:M％=2.54+8.69(Pp/Ps)+0.23(Rp)-0.04(DPA),以及国人“移行段”肺小动脉中层厚度的分析标准,供临床参考。

The efficacy of surgery for congenital heart defect (CHD) with secondary pulmonary hypertension (PH)has been controversed for a long time. Authors analysis the quantitative and qualitative lung biopsy of 30 cases of research group (CHD with PH) and 11 cases of contrast group with double-blind method in two interval times. The result demonstrated the quantitative analysis of thickness of medial muscular coat of the transitional pulmonary arterioles had better relationship with the clinical early post-operative course (P<0.05). Meassured pathological change was clear and stable with a good repeated result (r = 0.98, P<0.01) and had a good relationship with hemodynamic data such as (Pp/Ps) (r=0.80, P<0.01). The equation, which was made from computer in regressive analysis, M% = 2.54+8.69 (Pp/Ps) + 0.23(Rp) - 0.04(DPA) (F = 0.2, P< 0.01). was suggested by the authors with a primary standard of national thickness of the medial muscular coat of the 'transitional pulmonary arterioles'.