风湿性心脏病二尖瓣置换术后左室形态及功能改变与心肌病变的关系  

Relationship between change of morphosis and function of left ventricl e and pathologic changes of myocardium after mitral valve replacement with rheum atic heart disease

作　　者：张近宝[1] 王一苇[2] 郑晓荣[3] 刘维永[1] 李军[4] 朱霆[4] 

机构地区：[1]第四军医大学西京医院心血管外科中心,陕西西安710033 [2]第四军医大学西京医院血液科,陕西西安710033 [3]第四军医大学西京医院综合诊疗科,陕西西安710033 [4]第四军医大学西京医院超声诊断科,陕西西安710033

出　　处：《第四军医大学学报》2003年第2期132-135,共4页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金资助项目 (39870 790 )

摘　　要：目的 :探讨风湿性心脏病二尖瓣置换术后左室形态及功能改变与心肌病变的关系 .方法 :用彩色多普勒检测患者术前及术后心功能并进行对比 ,同时用免疫组化法检测患者心肌中增殖细胞核抗原 (proliferatingcellnuclearantigen ,PCNA)表达量 ,并将其与患者术前心功能进行对比分析 .结果 :心肌病变较轻者 ,行二尖瓣置换术后 ,心功能得到明显改善 .心肌本身病变较重者 ,行二尖瓣置换术后 ,心功能未见明显改善 ,甚至下降或近期死亡 .结论 :风湿性心脏病二尖瓣置换术后 ,左室形态及功能因心肌病变的不同而得到不同程度的改善 .AIM: This study aims to investigate the rel at ionship between the morphosis and function of left ventricle and the pathologic changes of myocardium following mitral valve replacement in patients with the rh eumatic heart disease. METHODS: Heart functions before a nd after operation were measured with the echocardiography. The expression of pr oliferating cell nuclear antigen (PCNA) was measured by immunohischemical staini ng .The results were analyzed to see if there is a correlation between the morph osis and function of left ventricle and the pathologic changes of myocardium. RESULTS: The expression of PCNA in the myocardium of patie nts with rheumatic heart diseases was significantly higher than that of healthy adult control group and was positively correlated with the cardiac function. CONCLUSION: The myocardium fibrosis in the myocardium of rh eumatic heart diseases is an important factor that exerts an effect on the cardi ac function after mitral valve replacement.

关 键 词：风湿性心脏病 二尖瓣置换术 左室形态 心肌病变 心室功能 

分 类 号：R654.2[医药卫生—外科学]