轻中型高血压病患者与正常血压人群肺功能状态的前瞻性单盲对比研究

对102例未经正规治疗的轻中型高血压病（EH）病人和100例正常血压者的临床肺呼吸功能指标进行前瞻性单育对照研究。结果表明，EH组在反映肺呼吸功能的多项指标（用力肺活量：第一秒时间肺活量、最大呼气中段流速、最大肺通气量、呼气峰值流速）均较对照组降低（P＜0．05～0．001）。提示：EH病人肺呼吸功能受到损害，其中EH合并左室肥厚者较非左室肥厚者肺功能损害更为严重（P＜0．05～0．01）。左室舒张功能和排血能力受损引起肺循环压力增高以及EH对支气管动脉的损害可能是导致肺器官的结构和功能障碍的主要原因。提出未来的EH防治战略应将肺器官保护问题作为一个重要的指导原则。     

高血压病患者肺通气功能和弥散功能的变化

目的　探讨不同分级、危险度分层的原发性高血压病 (essential hypertension,EH )患者的肺功能改变及其临床意义。方法　对 6 7例未经正规治疗的 EH患者和 6 3例血压正常者的肺通气功能 (用力肺活量 FVC、第一秒用力呼气量FEV1 、最大呼气中段流量 MMEF、最大通气量 MVV)和弥散功能 (肺一氧化碳弥散量 DLCOSB)进行前瞻性单盲对照研究。结果　 (1) EH组 FVC、FEV1 、MMEF、MVV、DLCOSB与正常对照组比较差异有显著性 (P<0 .0 0 1)。(2 ) 2、3级 EH患者肺功能较 1级 EH患者肺功能降低 ,两者在 FVC、FEV1 的差异有非常的显著性 (P<0 .0 0 1) ,而在 MMEF、MVV、DLCOSB的差异无显著性 (P>0 .0 5 )。(3)与低危组相比 ,中危组 EH患者的各项肺功能指标都有所降低 ,但其中仅 FEV1的差异具有显著性 (P<0 .0 5 ) ;高危 /极高危组 EH患者的肺功能皆降低 ,其中 FVC、FEV1 、MMEF的差异具有显著性(P<0 .0 2～ 0 .0 0 1) ,而 MVV、DLCOSB的差异无显著性 (P>0 .0 5 )。 (4)与中危组相比 ,高危极高危组 EH患者肺功能降低 ,其中 FVC、FEV1 的差异具有显著性 (P<0 .0 0 1) ,而 MMEF、MVV、DLCOSB的差异不具有显著性 (P>0 .0 5 )。结论　 EH患者肺通气功能和弥散功能减低 ,并有随血压分级和危险度分层的加重而减低趋势     

原发性高血压患者右心功能与肺功能的相关性研究

目的探讨原发性高血压（EH）患者右心功能与肺通气功能的相关性。方法①右心功能测定：对60例EH患者和对照组20例在二维超声心动图（2DE）上用改良Simpson法计算右室收缩功能。先测出整个心室的心腔容积（Vvl，含室间隔）及室间隔与左心室腔所占的容积（Vlvivs），两者相减即可得出右心室腔的容积（RVV，RVV=Vvl—Vlvivs）。测算右心功能指标：右心室射血分数（RVEF）、右室每搏输出量（RVSV）、右心室心输出量（RVCO）等。②所有受检者行肺通气功能检测，结果与RVEF进行相关分析。结果①右心功能测定结果：与对照组相比，各级EH患者右室收缩功能均有不同程度减低，而以3级高血压较显著（RVEF分别为68．16±6．26和48．94±6．09，P〈0．01）。②肺功能结果：EH各组肺功能指标较对照组均降低，但仅与2、3级组间的差异有统计学意义；与1级组相比，2级组用力肺活量（FVC）、第1秒用力呼气量（FEV1）降低；3级组中FVC、FEV1、最大呼气中段流量（MMEF）、肺总量（TLC）均降低（P〈0．05或P〈0．01）；EH3级组中FVC较2级组降低（2．04±0．27比2．39±0．45，P〈0．01）。③RVEF与FVC、FEV1、MMEF、MVV、TLC测值间的相关系数分别为0．93、0．91、0．59、0．51和0．77，提示RVEF主要与FVC、FEV1呈正相关（P〈0．01）。结论①EH患者右室收缩功能减低，以3级高血压较显著。②EH患者存在肺通气功能的损害，并随血压分级的加重而呈减低趋势。③EH患者RVEF与肺通气功能指标的变化可能存在一定的相关性。     

慢性阻塞性肺疾病患者肺通气功能程度与夜间低氧发生的关系

目的 探讨慢性阻塞性肺疾病(COPD)患者肺通气功能程度与夜间低氧发生的关系.方法 选择稳定期COPD患者48例,其中肺通气功能为轻度、中度、重度、极重度者均为12例,采用肺功能检测仪检测患者的肺通气功能指标,监测整夜多导睡眠图观察夜间血氧指标,并对其肺通气功能与夜间血氧指标进行相关分析.结果 随病情程度加重,COPD患者的第1秒用力呼气容积占预计值百分比、第1秒用力呼气容积/肺活量、肺活量、最大呼气流量、平均血氧饱和度、清醒时平均血氧饱和度、最低血氧饱和度逐渐降低,残气容积(RV)、RV/肺总量、氧减饱和度指数、血氧饱和度低于90％的时间占睡眠总时间的百分比逐渐升高(P＜0.05或＜0.01).COPD患者的肺通气功能程度与平均血氧饱和度呈负相关(P＜0.05).结论 COPD患者夜间低氧发生与其肺通气功能程度相关.     

AT1拮抗剂氯沙坦降压治疗对患者血浆一氧化氮的影响

目的　探讨血管紧张素Ⅱ的Ⅰ型受体 (AT1)拮抗剂氯沙坦对高血压患者除降压作用外对血浆一氧化氮(N0 )的影响。方法　应用硝酸还原酶法对 10 0例高血压患者 (分为氯沙坦治疗组及洛汀新治疗组各 50例 )治疗前后及血压正常之对照组 3 0例的血浆N0浓度进行测定。结果　高血压组 (两组 )患者治疗前血浆N0浓度明显低于正常对照组 (P <0。 0 5) ,以氯沙坦和血管紧张素转换酶抑制剂 (A CEI)洛汀新有效降压后血浆N0浓度均有明显提高 ,差异有统计学意义 (P <0 0 5)。治疗前后两治疗组间的血浆N0浓度无差异。结论　氯沙坦与洛汀新除有良好的降压作用外均可升高高血压患者的血浆NO水平 ,并提示该两种药物降压治疗对患者血浆NO有相似的升高作用     

风湿性二尖瓣狭窄患者肺功能与血流动力学相关分析

目的：评价风湿性二尖瓣狭窄（ＭＳ）患者心肺功能的相互关系。方法：对３２例ＭＳ患者进行肺功能和右心导管检查。统计处理采用典型相关分析。结果：小气道功能指标最大呼气中段流速、５０％肺活量用力呼气流速和２５％肺活量用力呼气流速代表主要肺功能改变，肺小动脉阻力、肺动脉压、肺小动脉嵌顿压代表主要血流动力学改变；对血流动力学变化较敏感的肺功能指标是潮气量、５０％肺活量用力呼气流速和２５％肺活量用力呼气流速比值、肺活量、最大呼气中段流速；对肺功能变化较敏感的血流动力学指标是心输出量、肺血管阻力、肺小动脉嵌顿压。结论：血流动力学与肺功能之间有显著的相关关系。     

醛固酮拮抗剂对原发性高血压心肌纤维化的影响

目的 :观察醛固酮拮抗剂———螺内酯对原发性高血压 (EH)患者心肌纤维化的影响。方法 :将 5 7例EH患者随机分为A组 (2 9例 ) :单用贝那普利 (10mg/d) ,B组 (2 8例 ) :等量贝那普利加螺内酯 (2 0mg/d)。应用放射免疫分析技术测血清Ⅲ型前胶原末端肽 (PⅢP)、Ⅳ型前胶原末端肽 (PⅣP)含量 ;采用多普勒超声心动图仪测定左室结构及舒缩功能变化。结果 :两组患者治疗 6个月后 ,平均动脉压、PⅢP、PⅣP及室间隔舒张末期厚度、左室后壁厚度、左室重量指数较治疗前均有下降 (P <0 .0 5或 <0 .0 1) ,以B组下降更明显 ;舒张末期左室内径A组治疗前后无变化 (P >0 .0 5 ) ,B组治疗后有所下降 (P <0 .0 5 ) ;两组治疗后二尖瓣血流舒张早期流速和心房收缩期流速之比均有上升 (P <0 .0 5或 <0 .0 1) ,以A组上升更明显 (P <0 .0 5 ) ;左室收缩功能指标治疗前后无明显变化。两组治疗后均无明显副作用发生。结论 :EH患者在接受血管紧张素转换酶抑制剂治疗同时 ,再联用螺内酯 ,能更完全抑制肾素 血管紧张素 醛固酮系统 ,避免“醛固酮逃逸”现象 ,显著减轻心肌纤维化程度 ,改善左室肥厚及心脏舒张功能     

吸入复方异丙托溴铵与异丙托溴铵对COPD肺功能的影响

目的 观察单剂量吸入复方异丙托溴铵与异丙托溴铵对慢性阻塞性肺疾病(COPD)患者静态肺功能的不同影响.方法 26例稳定期COPD患者随机分为两组,分别吸入复方异丙托溴铵和异丙托溴铵后,进行静态肺功能测定.结果 14例吸入复方异丙托溴铵的患者,第一秒用力呼气量(FEV1)和用力肺活量(FVC)、呼气流速指标均有显著改善,第一秒用力呼气量占肺活量比值(FEV1/FVC)无明显的改变;深吸气量(IC)增加;12例吸入异丙托溴铵的患者,FEV1,FVC,FEV1/FVC无显著改变,呼气流速指标亦无显著改变但IC增加.结论 单剂量吸入复方异丙托溴铵能够显著改善COPD患者肺通气功能.     

成年肺炎支原体肺炎患者的肺功能特点分析

目的分析成年肺炎支原体肺炎患者的肺功能特点。方法选取2014年11月—2016年10月在首都医科大学附属北京地坛医院住院及门诊就诊的普通肺炎患者30例(A组)、MPP患者30例(B组),另选取同期体检健康者30例作为对照组。分析A组和B组患者胸部CT检查结果及肺功能检查结果,比较3组受试者肺功能指标及MPP患者治疗前后肺功能指标。结果 (1)胸部CT检查结果:A组和B组患者均以斑片渗出样改变为主,分别占70.0%、53.3%。肺功能检查结果:A组患者肺功能正常者占63.3%,肺功能障碍主要表现为阻塞性通气功能障碍,占13.3%;B组患者肺功能正常者占43.3%,肺功能障碍主要表现为阻塞性通气功能障碍,占33.3%。(2)3组受试者最大肺活量占预计值百分比(VCmaxpred%)、残气量占预计值百分比(RVpred%)、肺总量占预计值百分比(TLCpred%)、肺泡通气量占预计值百分比(VApred%)、用力肺活量占预计值百分比(FVCpred%)、呼气峰值流速占预计值百分比(PEFpred%)比较,差异均无统计学意义(P0.05);B组患者潮气量占预计值百分比(VTpred%)和最大通气量占预计值百分比(MVVpred%)高于对照组和A组(P0.05);A组和B组患者残气量与肺总量比值占预计值百分比(RV/TLCpred%)、气道阻力占预计值百分比(Rtotpred%)高于对照组,第1秒用力呼气容积占预计值百分比(FEV_1pred%)、第1秒用力呼气容积与用力肺活量比值占预计值百分比(FEV_1/FVCpred%)、25%肺活量用力呼气流速占预计值百分比(MEF_(25)pred%)、50%肺活量用力呼气流速占预计值百分比(MEF_(50)pred%)、75%肺活量用力呼气流速占预计值百分比(MEF_(75)pred%)、最大呼气中段流速占预计值百分比(MMEF_(75/25)pred%)及一口气一氧化碳弥散量占预计值百分比(DLCO-SBpred%)低于对照组(P0.05)。(3)MPP患者治疗前后VTpred%、RVpred%、TLCpred%、RV/TLCpred%、MVVpred%及DLCO-SBpred%比较,差异均无统计学意义(P0.05);治疗后VCmaxpred%、VApred%、FEV_1pred%、FVCpred%、FEV_1/FVCpred%,PEFpred%、MEF_(25)pred%、MEF_(50)pred%、MEF_(75)pred%及MMEF_(75/25)pred%高于治疗前,Rtotpred%低于治疗前(P0.05)。结论 MPP患者存在气流受限,主要表现为通气功能、弥散功能障碍及气道阻力增加,而抗感染治疗可有效改善患者肺功能;MPP和普通肺炎患者肺功能无明显差异。     

盐酸二甲双胍对原发性高血压伴糖耐量减低患者的疗效观察

目的 :观察二甲双胍对原发性高血压 (EH)伴糖耐量减低 (IGT)患者糖代谢、胰岛素敏感性的影响。方法 :4 3例EH伴IGT患者分组进行非诺地平降压治疗 (Ⅰ组 )和非诺地平降压加二甲双胍治疗 (Ⅱ组 ) ,比较两组患者治疗前后糖代谢、胰岛素敏感性、脂代谢和体重指数的变化。结果 :Ⅱ组患者IGT、胰岛素敏感性明显改善 ,与Ⅰ组比较 ,差异有统计学意义 (P <0 .0 5 ) ;血脂水平、体重指数较Ⅰ组也有所下降 ,但两组比较差异无统计学意义 (P >0 .0 5 )。结论 :二甲双胍能较好地用于EH伴IGT患者的干预治疗     

Ventilatory parameters in healthy nonsmoking adults of Adriatic islands (Yugoslavia).

Forced expiratory volumes and flows (forced vital capacity (FVC), forced expiratory volume in one second (FEV1) peak expiratory flow (PEF), maximal expiratory flow at 25% (MEF25%), 50% (MEF50%) and 75% (MEF75%) of the FVC) have been measured in 909 healthy nonsmoking men and women, ranging in age from 18-86 yrs, who live on Eastern Adriatic islands (Yugoslavia). This area is essentially free from air pollution. The results have been analysed in terms of age and height and regression equations for each sex were derived. The equations for FVC and FEV1 were reliable and those for forced expiratory flows were not. Comparisons were made with prediction equations derived for other populations, especially with those which are commonly used in daily medical practice.     

Relationship of static respiratory muscle pressure and maximum voluntary ventilation in normal subjects

40 normal subjects performed spirometry, maximum voluntary ventilation (MVV), and tests of static inspiratory (Pi max) and expiratory (Pe max) respiratory muscle pressure. Forced expiratory volumes in 0.5 (FEV0.5), in 0.75 (FEV0.75), and 1 sec (FEV1) correlated significantly with MVV (r = 0.805, 0.804, 0.779, respectively). When Pi max was considered as a second independent variable, the probability of predicting MVV from timed forced expiratory volumes was enhanced (r = 0.914, 0.900 and 0.872 for FEV0.5, FEV0.75, and FEV1, respectively). Statistical analysis indicated that multiple regression with Pi max was superior to regression with timed forced expiratory volume alone in the prediction of MVV. For any given FEV1, however, Pi max was widely dispersed (range: -60 to -200 cm H2O). MVV values, expressed as percentage difference between largest and smallest value, varied less than did Pi max. Pe max, vital capacity, height and age did not enhance the ability of timed forced expiratory volumes to predict MVV. These data indicate that while respiratory muscle strength is important for sustaining maximal ventilation, the MVV is not a sensitive indicator of respiratory muscle strength.     

老年慢性阻塞性肺疾病患者营养状况与肺通气量的关系

目的研究慢陛阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）患者营养状况与肺通气功能的关系。方法对217例患者进行以身体组成评价法（BCA）营养状况调查。根据其营养评价结果分为营养良好组和营养不良组,两组进行肺通气功能测定,观察指标包括：最大通气量（MVV）,用力肺活量（FVC）,第1秒用力呼气容积（FEV1）,最大呼气流量（PEF）。结果在调查的217例患者中,有67例患者营养状况良好,占30．87％,有150例COPD患者被评为营养不良,营养不良发生率为69．13％。营养不良组的肺通气量指标MVV％（36．21±17．36）、FVC％（75．42±19．65）、FEV1％（41．92±16．29）、PEF％（36．06±17．25）均低于营养良好组MVV％（59．25±22．61）、FVC％（93．19±15．32）、FEV1％（52．3±14．43）、PEF％（68．19±24．23）,差异有统计学意义（P〈0．05）。结论COPD患者的营养状况评价结果均不理想,而营养不良会使呼吸肌储备力量下降及呼吸肌容易疲劳,导致肺通气功能降低,所以改善COPD患者营养不良的发生,对肺通气功能恢复有重要意义。     

Forced expiratory parameters in healthy preschool children (3-6 years of age)

In a group of 173 healthy preschool children 3-6 years of age (body height, 90-130 cm; 102 boys and 71 girls) out of total 279 children examined, maximum expiratory flow-volume (MEFV) curves were recorded in cross-sectional measurements. The majority (62%) of preschool children were able to generate an MEFV curve as correctly as older children. From the curves, maximum expiratory flows at 25%, 50%, and 75 % of vital capacity (MEF(25), MEF(50), and MEF(75)), peak expiratory flow (PEF), forced expiratory volume in 1 sec (FEV(1)), forced vital capacity (FVC), and area delineated by MEFV curve (A(ex)) were obtained. The purpose of the study was to establish reference values of forced expiratory parameters in preschool children suitable for assessment of lung function abnormalities in respiratory preschool children. The values of the studied parameters increased nonlinearly and correlated significantly with body height (P < 0.0001); the correlation was much lower with age. A simple power regression equation was calculated for the relationship between each parameter and body height. A best-fit regression equation relating functional parameters and body height was a power function. Based on the obtained regression equations with upper and lower limits, we prepared tables listing reference values of forced expiratory parameters in healthy Caucasian preschool children, against which patients can be compared. No statistically significant gender differences were observed for MEF(25), MEF(50), MEF(75), PEF, FEV(1), FVC, and A(ex) by extrapolation. The reference values were close to those obtained in our older children. A decline of the ratios PEF/FVC, FEV(1)/FVC and MEF/FVC with increasing body height suggested more patent airways in younger and smaller preschool children.     

50例健康老年人肺功能10年随访观察

目的为临床和基础研究提供健康老年人肺功能各项指标随增龄改变的参考资料。方法采用日本Ｃｈｅｓｔａｃ６５型肺功能检查仪,按常规方法进行肺功能检查。结果用力肺活量（ＦＶＣ）每年下降００３２Ｌ,第１秒用力呼气量（ＦＥＶ１）每年下降００３Ｌ,ＦＥＶ１占用力肺活量比值（ＦＥＶ１％）每年下降０１５１％,呼气流量峰值（ＰＥＦＲ）每年下降０１１８Ｌ／ｓ,最大呼气中段流量（ＭＭＥＦ）每年下降００４Ｌ／ｓ,最大通气量（ＭＶＶ）每年下降０８７６Ｌ,肺活量（ＶＣ）每年下降００４Ｌ,残气容积（ＲＶ）每年升高００３３Ｌ,功能残气量（ＦＲＣ）每年升高００３３Ｌ,残气容积／肺总量（ＲＶ／ＴＬＣ）每年升高０５９６％。戒烟组的健康老年人ＶＣ、ＦＶＣ、ＦＥＶ１、ＲＶ、ＲＶ／ＴＬＣ与从不吸烟健康老年人比较差异有显著性;不同年龄组的健康老年人肺功能下降不明显。结论肺功能各项指标随增龄而改变,健康老年人各年龄组肺功能改变不明显,吸烟对健康老年人肺功能改变有一定影响。     

Assessment of pulmonary function tests in cardiac patients

This study was aimed to assess the pulmonary function tests (PFTs) in cardiac patients; with ischemic or rheumatic heart diseases as well as in patients who underwent coronary artery bypass graft (CABG) or valvular procedures. For the forty eligible participants, the pulmonary function was measured using the spirometry test before and after the cardiac surgery. Data collection sheet was used for the patient’s demographic and intra-operative information. Cardiac diseases and surgeries had restrictive negative impact on PFTs. Before surgery, vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), ratio between FEV1 and FVC, and maximum voluntary ventilation (MVV) recorded lower values for rheumatic patients than ischemic patients (P values were 0.01, 0.005, 0.0001, 0.031, and 0.035, respectively). Moreover, patients who underwent valvular surgery had lower PFTs than patients who underwent CABG with significant differences for VC, FVC, FEV1, and MVV tests (P values were 0.043, 0.011, 0.040, and 0.020, respectively). No definite causative factor appeared to be responsible for those results although mechanical deficiency and incisional chest pain caused by cardiac surgery are doubtful. More comprehensive investigation is required to resolve the case.     

Maximal ventilation at rest and exercise in patients with chronic pulmonary disease

74 subjects of different ages: normal children, 19 boys (A) and 7 girls (C) aged between 11 and 15 years; asthmatic boys (n = 7, group B) and girls (n = 7, group D), with similar ages; normal male adult subjects (n = 10, group E) and pulmonary patients with restrictive (n = 8, group G) or obstructive (n = 16, group F) ventilatory impairment, were submitted to measurements of vital capacity (VC), forced expiratory volume in 1 s, (FEV1), maximal voluntary ventilation (MVV), maximal peak expiratory (PEF) and inspiratory (PIF) flows at rest, and two maximal exercise stress tests in which the ventilation at maximal exercise (MEV) were retained. Indirect MVV was obtained by multiplying the FEV1 by 35 and 37.5. The correlation coefficients between MVV and VC, FEV1, PEF and PIF were always as high as r greater than 0.76. (p less than 0.001), with a discrepancy between the calculated and measured MVV. The average ratio MVV/FEV1 always exceeds 39 and is much higher in groups B, C and G. The mean percent values of the ratio MEV/MVV were 0.63 in normal men and 0.74 in normal boys. In patients, this ratio is higher than in adult normals: F = 0.81 and G = 0.88, and is not due to methodological errors, but seems to correspond to several physiological features playing only a role during exercise (MEV). This work shows the difficulty in predicting correctly the MVV at rest and in assessing the ventilatory reserve during maximal exercise in chronic pulmonary patients.     

老年代谢综合征患者肺功能的变化

目的探讨老年代谢综合征(MS)患者肺功能的变化。方法检测58例老年代谢综合征(MS)患者和58例非代谢综合征(non-MS)老年人肺功能,并比较两组肺功能变化。结果老年MS组用力肺活量(FVC)、第1秒用力呼气容积、最大通气量、肺一氧化碳弥散量均明显低于non-MS组(P<0.01)。结论老年MS患者较non-MS老年人有明显的肺功能减退。     

Chest mechanics in morbidly obese non-hypoventilated patients

Seventy-seven patients with morbid obesity, body mass index (BMI) 40-69.9 kg m(-2), who were candidates for gastroplasty, were studied in our laboratory as part of a pre-operative survey. They had no complaints other than obesity and were not cyanotic. A group of 28 lean subjects (BMI 20-29.8 kg m(-2)) who were candidates for abdominal surgery, without any respiratory complaint, were included as controls. For each patient a pulmonary function test was performed, measuring slow vital capacity with expiratory residual volume (ERV), forced vital capacity (flow/volume) and maximal voluntary ventilation (MVV). In obese patients the MVV is reduced as BMI increases. This results in the reduction of expiratory flows and volumes. Forced expiratory volume in 1 sec (FEV1) is reduced in proportion to the FVC reduction and is related to MVV. It is suggested that the main consequence of the burden of the chest wall by increased adipose mass is a reduction in its compliance, making inspiration increasingly difficult, and resulting in lower static volumes and flows.     

Correlation between symptom score, wheeze, reversibility of pulmonary function tests and treatment response in asthma

Asthma management is a major concern because some asthmatic patients either do not respond or else hardly respond to treatment. Therefore in the present study, an attempt has been made to determine the predictors of treatment response in asthmatic patients. Thirty six asthmatic adults including 13 male and 23 female were studied during a 3 month treatment period. Asthma symptom score (SS) and wheezing were recorded before and after treatment. Pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal expiratory measured at the beginning and the end of the study. The increase in PFT values 10 mm after 200 ?,tg inhaled salbutamol (in percentage) was considered as reversibility in airway constriction. There were significant improvements in SS (p相似文献