上肺血管扩张对左心衰竭的诊断意义

目的：胸片显示上肺血管扩张对诊断左心衰竭的意义，文献报导较少，而临床多见此征象。研究该征象的病理基础及产生原因，可提高对左心衰的早期认识。方法：收集近几年确诊、资料较全的３５例各种疾病所致左心衰病例，观察胸片并测量上肺血管宽度，进行综合分析。结果：３５例（冠心病６例、高血压性心脏病１４例，肺源性心脏病合并左心衰４例；充血性心肌病及病毒性心肌炎１１例）均有上肺血管扩张表现。上肺血管宽４３～６７ｍｍ，平均５１ｍｍ。１２例左侧位上肺静脉均较上肺动脉宽１倍以上。部分胸片伴有肺淤血及肺间质水肿。结论：上肺血管扩张可作为左心衰的一项诊断依据。

Significance of Superior Pulmonary Vessel Dilatation in theDiagnosis of Left Heart Failure:an Analysis of 35 Cases

Objective:To explore the significance of superior pulmonary vessel dilatation indicated by thorax X-ray film in the diagnosis of left hart failure. The sign is usually seen in the clinic, but the report about this is rare.To study the reasons and pathology of the sign can improve the early diagnosis on left heart failure. Methods:We collected 35 cases of left heart failure caused by various diseases with detail records over the past several years,then observed the X-ray films and measured the widths of superior pulmonary vessels, and analyzed them.Results:The dilatation is seen in all cases, including 6 cases of coronary heart disease,14 cases of hypertension cardiomyopathy, 4 cases of cor pulmonale with left heart failure and 11 cases of congestive cardiomyopathy and viral myocarditis.The widths of the vessels range from 4 3 to 6 7 mm, and the mine width is 5 1 mm,Among 12cases of them the widths of superior pulmonary veins are more than 2 times than that of the arteries in the left side films. Some cases accompany pulmonary congestion and pulmonary interstitial edema. Conclusion:The study implicates that the sign of superior pulmonary vessel dilatation is valuable to diagnosis of left heart failure.