闭塞性肺动脉高压的自然病程和长期疗效的分析

本文总结了59例闭塞性肺动脉高压的自然病程和15例长期治疗的效果。生存曲线显示2年生存率为76.72％,5年为63.37％。与预后相关的单因素有病程、心脏功能、PaO_2、HR和CO;多因素有病程、PaO_2、SaO_2、病因、PAP及RAP。长期治疗的有效率为73.33％。强调了抗凝治疗的重要性,并讨论了硝苯吡啶治疗的指征和利弊。

Analysis of Natural History and Long-term Follow-up of 59 Patients with Obliterative Pulmonary Hypertension (OPH)

The diagnosis of OPH was made by clinical and hemodynamic data in 59 patients , including 30 cases of unexplained pulmonary hypertension, 26 cases of pulmonary embolism and 3 others. The survival curve showed that the two- year survival rate of the patients was 76.72%, and the five-year rate was 63.37%. The single correlation factors influencing prognosis were the interval from onset of symptoms to diagnosis (course), cardiac function, PaO2, SaO2, cause of disease, pulmonary artery pressure and right atrial pressure. The outcome of long-term treatment (mean 4.2 years) in 15 patients with OPH was as follows: remarkable improvement in 8 cases, amelioration in 3, no change in 2 and deterioration in 2. The total effective rate was 73.33%. The importance of anticoagulant therapy and the use of nifedipine are discussed.