130例Ⅱ孔房间隔缺损伴肺动脉高压患者的临床分析

目的 :探讨Ⅱ孔房间隔缺损 (房缺 ,ASD)继发肺动脉高压的相关因素以及妊娠在女性房缺患者肺动脉高压形成过程中的作用。方法 :收集 1993年 1月至 2 0 0 0年 4月北京安贞医院收治的伴肺动脉高压的房缺患者 130例。按照年龄、性别、房缺直径、肺阻力大小分组 ,进行回顾性临床分析。结果 :1 随着年龄的增长 ,男性和女性房缺患者的肺动脉高压发病率均增高 ,而女性更为显著。 2 房缺直径大小与肺动脉压力间无显著相关。 3 有过妊娠史的女性患者 ,继发肺动脉高压的趋势较无妊娠史的女性患者和同年龄的男性患者更明显。结论 :房间隔缺损继发肺动脉高压有多种相关因素。有过妊娠史的女性房缺患者 ,妊娠期间血容量显著增加以及血液高凝状态造成远端肺小动脉血栓形成 ,可能参与并促进了肺动脉高压的发展。

Clinical analysis of 130 cases of secundum atrial septal defect with pulmonary hypertension

Objective:This study sought to investigate the possible risk factors contribute to the developing of pulmonary hypertension(PH) in secondary atrial septal defects(ASD) and assess the role of gestation that maybe acted druing this course.Method:130 cases of ASD with PH were admitted in Anzhen hospital from January,1993 to April,2000.Perform retrospective analysis by dividing them into groups according to age,sex,size of the ASD and pulmonary arteriolar resistance.Result:(1) Along with aging,morbidity of PH in either sexual groups increased.However,it was more preponderance in female than male patients.(2) There were no significant relationship between the size of the defect and the development of PH.(3) Compared with the female patients who had no gestation history and the male patients of ASD in the same age,female patients of ASD with gestation history were more inclined to develop into pulmonary hypertension.Conclusion:There were many factors participate in the attack of PH.In female ASD patients,during gestation,expansion of blood volume and the formation of thrombi in the small pulmonary arteries resulted from blood hypercoagulable state may play important parts in the development of pulmonary hypertension.