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目的 :了解法洛四联症患者肥大右室心肌间质胶原改建与右室功能的关系。方法 :用生化方法定量分析 2 2例法洛四联症患者 (病例组 )和 8例非心血管及胶原系统疾病尸检者 (对照组 )的右室心肌间质中的胶原含量和 / 型胶原比值 ,并用右室穿刺法测定反映法洛四联症患者右室收缩及舒张功能的 dp/ dtmax及 - dp/ dtmax。结果 :病例组心肌每 mg总蛋白内含羟脯氨酸 (14.85± 2 .48)μg,较对照组 (7.5 5± 1.89)μg明显增多 (P <0 .0 5 ) ; / 型胶原比值为 5 .10± 1.84,较对照组 2 .2 7± 0 .5 8显著增高 (P <0 .0 5 ) ;病例组右室心肌间质胶原含量与术前、术后 dp/ dtmax无明显相关 ,而与术前、术后 - dp/ dtmax呈明显的负相关 ;其 / 型胶原比值与术前、术后dp/ dtmax及 - dp/ dtmax无相关。结论 :法洛四联症肥大右室心肌间质存在以胶原含量增多和 / 型比值增高为特点的胶原改建以及右室的舒张功能的下降 ,且后者主要与胶原含量增多有关
Objective: To investigate the relationship between hypertrophic right ventricular myocardial interstitial collagen remodeling and right ventricular function in patients with Tetralogy of Fallot. Methods: Biochemical methods were used to quantitatively analyze collagen content and / or collagen in right ventricular myocardium of 22 cases of tetralogy of Fallot (case group) and 8 cases of autopsy of non-cardiovascular and collagen system disease (control group) Ratio, and dp / dtmax and - dp / dtmax were measured by right ventricular puncture to reflect right ventricular systolic and diastolic function in patients with tetralogy of Fallot. Results: The contents of hydroxyproline per mg of total protein in the myocardial tissue of patients in the study group were significantly higher than those in the control group (14.85 ± 2.48 μg vs 7.55 ± 1.89 μg, P <0.05) 5.10 ± 1.84, which was significantly higher than that of control group (P <0.05) (P <0.05). There was no significant correlation between the content of collagen in right ventricular myocardium and the preoperative and postoperative dp / dtmax , But negatively correlated with preoperative and postoperative dp / dtmax. The ratio of type I / collagen was not correlated with preoperative and postoperative dp / dtmax and - dp / dtmax. CONCLUSION: There is a decrease in collagen remodeling and right ventricular diastolic function in the tetralogy of Fallot hypertrophic right ventricular hypertrophy characterized by increased collagen content and increased / ratio, and the latter is mainly associated with increased collagen content