风湿性心脏瓣膜病肺小动脉Ⅰ、Ⅲ型胶原的改变及其意义

蒋迎九; 李朝先; 向小勇; 米粲; 李圆圆

doi:10.13406/j.cnki.cyxb.2003.03.010

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风湿性心脏瓣膜病肺小动脉Ⅰ、Ⅲ型胶原的改变及其意义

更新时间：2024-01-17

- 风湿性心脏瓣膜病肺小动脉Ⅰ、Ⅲ型胶原的改变及其意义
- Collagen changes of pulmonary arteriole in patients with rheumatic heart disease and its significance
- 重庆医科大学学报 2003年第3期页码：288-291
- 作者机构：
  
  1. 重庆医科大学临床学院胸心外科
  2. 重庆医科大学基础医学院病理教研室,重庆,400016
- 作者简介：
- 基金信息：
  
  重庆市科委基金资助项目（ 98-2 9）
- DOI：10.13406/j.cnki.cyxb.2003.03.010
  中图分类号： R541.2
- 纸质出版日期：2003，
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[1]蒋迎九,李朝先,向小勇,米粲,李圆圆.风湿性心脏瓣膜病肺小动脉Ⅰ、Ⅲ型胶原的改变及其意义[J].重庆医科大学学报,2003(03):288-291.

JIANG Yinjiu, et al. Collagen changes of pulmonary arteriole in patients with rheumatic heart disease and its significance[J]. Journal of Chongqing Medical University, 2003,(3):288-291.
[1]蒋迎九,李朝先,向小勇,米粲,李圆圆.风湿性心脏瓣膜病肺小动脉Ⅰ、Ⅲ型胶原的改变及其意义[J].重庆医科大学学报,2003(03):288-291. DOI： 10.13406/j.cnki.cyxb.2003.03.010.

JIANG Yinjiu, et al. Collagen changes of pulmonary arteriole in patients with rheumatic heart disease and its significance[J]. Journal of Chongqing Medical University, 2003,(3):288-291. DOI： 10.13406/j.cnki.cyxb.2003.03.010.

摘要

目的 :观察继发于风湿性心脏瓣膜病的肺血管壁胶原改变及其意义。方法 :对 79例风心病肺组织标本行免疫组织化学染色

观察测定其肺血管壁中ColⅠ、ColⅢ的变化

并与 10例正常肺组织进行比较。结果 :病例组肺血管壁ColⅠ、ColⅢ含量显著高于对照组。对 1～ 3级肺血管病变

ColⅠ、ColⅢ含量随病变加重而增多

而 4级病变中ColⅠ、ColⅢ含量与 3级病变比较并不增多。血管壁ColⅠ含量主要与肺血管病变分级、肺动脉平均压、心功能、年龄 4项因素有关。结论 :胶原增生参与了风心病肺血管的构形重建。重度肺动脉高压及肺血管病变并非风心病手术禁忌的原因可能与 4级肺血管病变血管壁中ColⅠ、ColⅢ改变并不比 3级病变重有关。主要决定肺血管病变可逆性的ColⅠ含量与多因素有关。

Abstract

Objective:To investigate the collagen changes of pulmonary arteriole and its significance in patients with rheumatic heart disease.Methods:The preoperative hemodynamic parameters were obtained by catheterization?The 79 cases of lung specimen for study group were taken from the right lower lobe after cardio-pulmonary bypass

and 10 cases for control group were from autopsy or biopsy.Immunohistochemical staining with antibodies against collagen type Ⅰ

type Ⅲ was performed by S-ABC method.The levels of collagen type Ⅰ and type Ⅲ were examined quantitatively under computerized image analysis system.The correlations were analyzed between the clinical data and collagen in pulmonary arteriole.Results:There were significantly higher levels of collagen type Ⅰ and type Ⅲ in pulmonary vessels of the study group than that of the control group.The worse the lesion was

the higher the levels of collagen type Ⅰ and type Ⅲ were for pulmonary vacular lesions of pathological grade 1 to 3

but for grade 4

the levels of collagen type I and type III were not higher than that of grade 3. The concentration of collagen type Ⅰ in arteriole wall was correlated with the factors such as the severity of pulmonary vascular lesions

mean pulmonary artery pressure

cardiac function and age. Conclusions:Proliferation of the collagen contributed to the formation and the maintenance of pulmonary hypertension and vascular lesions resulted from rheumatic heart disease. The content of collagen type Ⅰ and type Ⅲ in pulmonary vascular lesions of grade 4 resulted from rheumatic heart disease was not so much as that of grade 3.This was perhaps one of the reasons that why extreme pulmonary hypertension and severe pulmonary vascular disease were not contraindications for operation. If an operation is necessary

4 factors including pulmonary vascular lesion

pulmonary hypertension

age and heart function should be taken into consideration

because they had correlation with the content of collagen type I which was dominant in reversion of pulmonary vascular disease.

关键词

胶原风湿性心脏瓣膜病肺血管病变

Keywords

CollagenRheumatic heart diseasePulmonary vascular lesion

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