慢性肺心病肺动脉高压影响因素的探讨

作者观察了289例肺心病急性期患者低氧血症,高碳酸血症及PCV和BV增高对PPA的影响,结果78.9％患者PPA均有不同程度升高,其PPA值与PaO_2呈负相关,与PaCO_2,PCV及BV呈正相关。缺氧、酸中毒和BV增高均为引起PHT的可逆性因素,故长程氧疗,纠正酸中毒和改善高粘血症对防治肺心病PHT方面具有重要的意义。

INVESTIGATION ON INFLUENCING FACTORS OF PULMONARY HYPERTENSION IN CHRONIC COR PULMONALE

Observations were made on 289 cases ofchronic cor pulmonale in exacerbation as towhat influences of hypoxemia, hyper-capnia, high pack cell volume (PCV) andblood viscosity (BV) would be exerted ontheir pulmonary hypertension (PHT). Theresults showed that the mean pulmonary ar-tery pressure (pPA) was markedly increasedin 84 cases (29.1%), moderately and mildlyincreased in 67 cases (23.2%) and 77 cases(26.6%) respectively. In 61 cases (21.1%),however, the pPA was within normal limits.The correlation of pPA with PaO_2 value wasnegative, but the correlation of pPA withPaCO_2, PCV and BV values was positive.Such facts may indicate that the primaryetiological factors of PHT are hypoxemia andhypercapnia, while the high PCV and BVinduced by hypoxia are the factors that fur-ther aggravate the PHT. Experiments have indicated that hy-poxemia, hypercapnia,high BV, etc. are thereversable or functional factors of PHT inpatients with chronic cor pulmonale in ex-acerbation. Therefore, in addition to the basictreatment of anti-respiratory infection andimprovement of ventilation, using the long-term oxygen therapy, erythrapheresis andcalcium antagonists for the prevention andreversal of hypoxic PHT in chronic cor pul-monale is very important in the managementof such patients.