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先天性心脏病伴肺动脉高压患者双源CT肺血管影面积百分比与肺小动脉形态变化的关系(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第4期
页码:
484
栏目:
临床研究
出版日期:
2011-08-25

文章信息/Info

Title:
Relationship between percentage of pulmonary vascular area by dual-source computed tomography and pulmonary vascular micromorphological indexes in patients with congenital heart disease complicated by pulmonary hypertension
作者:
邓超1; 任恺1; 俞世强1; 杨剑1; 郑敏文2; 王哲3; 赵璧君1
第四军医大学西京医院：1.心血管外科，2.放射科，3.病理科，陕西 西安 710032
Author(s):
DENG Chao1;  REN Kai1;  YU Shi-qiang1;  YANG Jian1;  ZHENG Min-wen2;  WANG Zhe3;  ZHAO Bi-jun1
1.Department of Cardiovascular Surgery, 2.Department of Radiology, 3.Department of Pathology, Xijing Hospital, Xi’an 710032, Shaanxi, China
关键词:
双源计算机体层摄影术; 先天性; 心脏缺损; 高血压; 肺性; 活组织检查
Keywords:
dual-source computed tomography;  congenital heart defects;  pulmonary hypertension;  biopsy
分类号:
R541.1;R730.44 　
DOI:
61-1268/R.20110503.1524.016
文献标识码:
A
摘要:
目的:探讨先天性心脏病伴肺动脉高压(PH)患者双源CT肺血管影面积百分比［EA(%)=右肺层面中血管影面积和/层面中右肺总面积］与肺小动脉形态变化的关系。方法： 随机选取2009年1月~12月收治92例左向右分流先天性心脏病患者，按肺动脉压力情况分为3组，先心病不并发PH组（对照组）29例，肺动脉平均压(MPAP)<20 mmHg；先心病并发PH组(PH组)55例， 80 mmHg>MPAP>20 mmHg；先心病并发紫绀组8例(紫绀组)，MPAP>90 mmHg。术前行肺血管双源CT，测定EA(%)值。取肺组织进行活检，观察肺血管病理变化及肺小动脉形态学变化指标。结果： 肺活检切片按Heath和Edwards标准进行病理分级，无肺高压对照组29例，Ⅰ级11例，Ⅱ级16例，Ⅲ级19例，Ⅳ级9例；紫绀组(≥V级)8例。对照组EA(%)为9.37±0.13，；肺小动脉血管壁厚度占血管外径的百分比WT(%)为15.27±1.98，血管壁面积占血管总面积百分比WA(%)为21.13±4.30。参照对照组各项检查指标，随病理分级的增加，双源CT肺血管影EA(%)呈下降趋势，显影的肺血管面积占肺总面积比例减少； WT(%)及WA(%)均随病理分级增加呈上升趋势，各组之间有显著性差异（P<0.01），一定程度上反映了病理变化程度越重，肺血管壁增生、管腔萎缩越重。结论： 肺高压患者双源CT肺血管影EA(%)的变化在一定程度上能够反映肺动脉高压患者肺血管病理的变化。
Abstract:
AIM:To explore the relationship between the percentage pulmonary vascular area ［(EA(%)］ by dual-source computed tomography (CT) and the pulmonary vascular micromorphological indexes in patients with congenital heart disease complicated by pulmonary hypertension (PH). METHODS: Ninety-two patients with congenital heart disease were randomly selected and divided into three groups according to the extent of PH: No-PH group (29 patients) with preoperative mean pulmonary artery pressure (MPAP) <20mmHg, PH group (55 patients) with preoperative MPAP >20mmHg and <80mmHg, and cyanosis group (eight patients) with preoperative MPAP >90 mmHg. All patients had dual-source CT before surgery and EA(%) was calculated. Pulmonary vascular micromophological indexes were measured according to Heath-Edwards pathological grading. RESULTS: Eleven patients were grade I, 16 patients were grade Ⅱ, 19 patients were grade Ⅲ, 9 patients were grade Ⅳ, and 8 patients were grade V. With the increase of the PH grade, the EA(%) significantly decreased but the WT(%) and the WA(%) increased (P<0.01). CONCLUSION: The EA(%) and the pulmonary vascular pathological changes are related in patients with congenital heart disease complicated by PH and the EA(%) is helpful in evaluating the extent of PH.

参考文献/References

[1]Van Albada ME,Schoemaker RG,Kemna MS,et al.The role of increased pulmonary blood flow in pulmonary arterial hypertension[J].Eur Respir,2005,26(3):487-493.
[2]Simonneau G,Galie N, Robin LJ,et al.Clinical classification of pulmonary hypertension[J].J Am Coll Candiol,2004,43(12 Suppl S):5S-12S.
[3]刘维永,易定华.现代心脏外科治疗学[M].西安:世界图书出版公司,2009:548-552.
[4]Shimoda LA,Sham JS,Sylvester JT.Altered pulmonary vasoreactivity in the chronically hypoxic lung[J].Physiol Res,2000,49(5):549-560.
[5]Perloff JK,Hart EM,Greaves SM,et al.Proximal pulmonary arterial and intrapulmonary radiologic features of eisenmenger syndrome and primary pulmonary hypertension[J].Am J Cardiol,2003,92(2):182-187.

备注/Memo

备注/Memo:
收稿日期：2010-08-29.基金项目：陕西省科技计划项目资助2009K18-01（61）；西京医院学科助推计划项目资助（XJZT09Y02） 通讯作者：赵璧君，副教授，主要从事先心病的外科治疗研究Email:zhaobj@fmmu.edu.cn 作者简介：邓超，住院医师，博士生Email:dengchao1127@163.com
更新日期/Last Update: 2011-06-02