胎儿卵圆孔早闭4例尸体解剖分析  

Premature closure of foramen ovale of fetus: autopsy analyses of four cases

作　　者：商建峰[1,2] 陈东[1,2] 崔亚艳[1,2] 方微[1,2] 武迎[1,2] 王伟[1,2] 石凤茹 韩丽媛[1,2] 何怡华[1,3] 苟钟山[1,3] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所病理科,北京100029 [3]北京市心肺血管疾病研究所超声诊断科,北京100029

出　　处：《诊断病理学杂志》2015年第5期280-282,286,共4页Chinese Journal of Diagnostic Pathology

基　　金：北京市优秀人才资助项目(2012A003C34000001);首都医科大学基础临床科研合作基金课题(14JL56)

摘　　要：目的探讨胎儿卵圆孔早闭(PCEO)的尸体解剖学特点。方法收集4例卵圆孔早闭胎儿的临床资料,测量心脏的大体情况,观察镜下特点。结果 4例胎儿中,1例因胎儿窘迫就诊,3例为孕期超声心动图检查发现胎儿心脏畸形引产。病理解剖见心房扩张,以右心房明显,卵圆孔关闭呈膜状,3例可见卵圆孔痕迹,大小与正常卵圆孔一致;1例卵圆孔狭小,卵圆瓣贴附于卵圆孔上呈闭合状态;3例伴主动脉瓣闭锁及主动脉弓狭窄,2例伴二尖瓣闭锁,单心室及肺发育异常。镜下心肌呈缺血性改变,肺泡腔内出现渗出液及红细胞。结论卵圆孔早闭表现为胎儿期卵圆孔呈膜状闭合状态,可伴心房扩张或左心发育不良。Objective To investigate autopsy pathologic manifestations of premature closure of foramen ovale of fetus. Methods Four pathological specimens of premature closure of foramen ovale of fetus were studied for clinical symptoms, signs, the outlines of the heart and the microscopic characteristics. Results One case of fetus was because of fetal distress, 3 cases were cardiac abnormalities in pregnancy fetal echocardiography. There was atrial dilatation, and the right sided cardiac structures were significantly dilated as compared with the left. 3 cases of fossa ovalis were normal, but 1 case of fossa ovalis was narrow. There was of an unusual, fixed membrane-like structure occupying the fossa ovalis. 3 cases were aortic valve atresia and arcus aortae stenosis, and 2 cases were mitral atresia, single ventricle and pulmonary dysplasia. Microscopically, the myocardium was ischemic changes. Alveolar cavities appeared exudate and red blood cells. Conclusion Premature closure of foramen ovale is that an unusual membrane-like structure occupying the fossa ovalis. It can be associated with atrial dilatation or hypoplastic left heart.

关 键 词：卵圆孔早闭 胎儿 先天性心脏病 左心发育不良 

分 类 号：R541.1[医药卫生—心血管疾病]