BALLOON DILATATION PULMONARY VALVULOPLASTY IN PULMONARY STENOSIS

Abstract Balloon valvuloplasty was used to treat congenital pulmonary valve stenosis in 13 patients, 11 with isolated pulmonary stenosis, one associated with complex univentricular heart and tricuspid atresia, and one associated with tetralogy of Fallot. A balloon catheter was introduced through the pulmonary valve over a guidewire positioned in the distal pulmonary artery and inflated for 15 seconds on two or three occasions to 3 to 5 atmospheres and rapidly deflated. Marked improvement in pressure gradients was achieved in eight of the 11 patients with isolated pulmonary valve stenosis and symptoms disappeared in the only patient in this group who was symptomatic. The two patients with complex congenital malformations improved clinically. The procedure was without complication and satisfactory results have been maintained from two to twelve months later. The procedure offers effective treatment. We believe that pulmonary balloon valvuloplasty should be the initial treatment for isolated severe and moderate pulmonary valve stenosis.     

缺氧性肺动脉高压与肺腺泡内动脉构型重组

用光镜与电镜观察、形态测量等方法，研究了缺氧大鼠腺泡内肺动脉（ＩＡＰＡ）构型重组的发展过程及其与肺动脉高压（ＰＨＴ）之间的关系。结果发现，慢性缺氧能引起大鼠肺动脉压升高、ＩＡＰＡ构型重组和右心室肥大等３种改变密切相关。ＩＡＰＡ构型重组首先是内皮细胞肿胀增生，继而是中膜平滑肌细胞增生肥大，细胞外基质增多，以及无肌型动脉肌化等结构改变。本文认为，内皮细胞在ＩＡＰＡ构型重组中可能起关键性作用。ＩＡＰＡ构型重组是持续性ＰＨＴ的形态学基础。     

肺奴卡菌感染

报告４例并收集国内１９８０年以来报道的２２例肺奴卡菌感染病例。男女比为２．３：１，平均年龄４０岁。６９％有各种基础疾病，３４．５％有皮质激素治疗史，５０％有胸腔积液。死亡病例占３８％。原发感染者预后佳，继发感染者预后差。治疗首选磺胺药；脓胸及脓肿应及时引流。