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目的 :揭示风湿性心脏病合并肺动脉高压时肺肌型动脉病变特征。方法 :选择自 1997～ 2 0 0 0年 17例风湿性心脏瓣膜病合并肺动脉高压患者行病理分析 ,所有患者均于术中测主肺动脉压 ( PPA )和升主动脉压( PA) ,计算 PPA/PA比值 ,作为评价肺动脉高压的标准之一。测量肺活检标本中肌型动脉外径 ( D)和中层 ( M)、内膜 ( I)厚度 ,计算 M/D、I/D比值 ,作为评价肺血管改变的指标。用统计学方法对以上各参数进行比较。结果 :肺动脉高压组 M/D值与 I/D值增高 ,与正常对照组比较差异有显著性意义。结论 :肌型动脉壁肥厚、胶原和弹力纤维组织增生、小动脉肌型化是被动性肺动脉高压的主要病理改变之一。
Objective: To reveal the characteristics of pulmonary artery disease in rheumatic heart disease with pulmonary hypertension. Methods: Seventeen patients with rheumatic valvular heart disease complicated with pulmonary hypertension underwent pathological analysis from 1997 to 2000. All patients underwent PPA and PA measurements during operation. The mean arterial pressure / PA ratio, as one of the criteria for evaluating pulmonary hypertension. Pulmonary biopsy specimens were measured in diameter (D) and middle (M), intima (I) thickness, calculated M / D, I / D ratio, as an indicator of pulmonary vascular changes. Using statistical methods to compare the above parameters. Results: The M / D value and I / D value of pulmonary hypertension group were significantly higher than those of normal control group. Conclusion: The hypertrophy of muscular artery wall, hyperplasia of collagen and elastic fiber, and muscular arteriolarization are one of the main pathological changes of passive pulmonary hypertension.