风湿性心脏病左心房大小与心肌病理的关系及临床意义  

The Relationship of Left Atrial Size of Rheumatic Heart Disease to Myocardial Pathology and Its Clinical Implications

作　　者：徐志云 张宝仁 耿振江 郝家骅 贾朝相 蔡凯华[2] 刘振华[3] 

机构地区：[1]长海医院胸外科,200433 [2]长海医院病理科,200433 [3]第二军医大学训练部病理解剖学教研室,200433

出　　处：《第二军医大学学报》1991年第6期519-522,共4页Academic Journal of Second Military Medical University

摘　　要：作者分析了25例风湿性二尖瓣病变患者左心房大小与心肌病理改变的关系及其临床意义。结果显示左心房愈大,心肌病理改变愈重,两者有非常显著的相关性(P<0.01);左心房大小与心肌超微结构和膜ATPase组织化学改变也有一定的关系。左心房大小和心肌病理改变程度均与房颤(Af)的发生及复律效果有关。左心房容积>100ml/m^2,心肌病理改变多为中度以上,易伴发Af;Af病人左心房容积<150ml/m^2,心肌病理改变多为中度,电复律效果较好;左心房容积>200ml/m^2,有重度心肌病理改变,复律效果极差。因此,作者认为根据左心房大小可预测Af的发生以及选择性地施行电复律。The relation between left atrial (LA) size and myocardial pathological changes, and clinical implications were studied in 25 patients with- rheumatic mitral stenosis. The results showed that LA size was significantly correlated with pathological severity of myocardium (P<0.01). The larger the LA size, the severer the pathological changes. The LA size was also correlated with the changes of the ultrastructure and cellular membrane ATPase histochemical examination. Both LA size and the pathological severity of myocardium were significantly correlated with atrial fibrillation (Af) and cardioversion effects. Patients with LA volume> 100 ml/m2 and accompanied by moderate or severe pathological changes easily suffered from Af (P<0.01); Af cardioversion was effective in patients with LA volume<150ml/m2 and moderate pathological changes and almost ineffective in those with LA volume>200ml/m2 and severe pathological changes. The results suggest that occurence of Af may be predicated based on the LA volume and Af cardioversion should be selectively performed to obtain better results.

关 键 词：风湿性心脏病 左心房 心肌病变 

分 类 号：R541.2[医药卫生—心血管疾病]