COPD合并肺动脉高压诊治分析

目的 探讨COPD合并肺动脉高压临床诊断,常规COPD治疗与强调戒烟和氧疗疗效对比.方法本研究随机选取我院就诊确诊为COPD合并肺动脉高压的患者90例为研究对象,随机分为对照组和实验组A、B,对照组仅针对COPD进行规范化治疗,实验组A采取常规的COPD系统化治疗外还特别强调戒烟,实验组B在实验组A治疗的基础上加上无创正压通气治疗.处理6周后,观察肺动脉压的动态变化情况和动脉血气分析情况.结果 实验组A及实验组B对改善肺动脉高压及患者动脉血气上明显高于对照组,P〈0.05.实验组B与实验组A相比,患者肺动脉压降低明显,P〈0.05.结论 规范治疗COPD对COPD合并肺动脉高压患者有很好的疗效,正压通气治疗及戒烟能明显增加患者疗效,改善患者预后.

Analysis of diagnosis and treatment of COPD patients complicated with pulmonary arterial hypertension

Objective To investigate the clinical diagnosis of chronic obstructive pulmonary disease （COPD） complicated with pulmonary hypertension and to compare the curative effect between the routine treatment with emphasis on smoking cessation and oxygen therapy. Methods 90 COPD patients complicated with pulmonary hypertension randomly divided into 3 groups. The control group was given the standardized treatment only. The experimental group A was emphasized to give up smoking plus the standardized treatment, and the experimental group B were treated with noninvasive positive pressure ventilation on the basis. 6 weeks after the treatment, the dynamic changes of pulmonary artery pressure and arterial blood gas were observed and analyzed. Results The improvement of pulmonary artery pressure and arterial blood gas was more pronounced in the experimental group A and B than in the control group （ P 〈 0. 05 ）, and the pulmonary hypertension decreased more obviously in the experimental group B than in the group A （ P 〈 0. 05 ）. Conclusion The stand- ard treatment of COPD has good curative effect on patients with COPD complicated with pulmonary hypertension, and positive airway pressure treatment and smoke abatement can significantly increase the curative effect and improve their prognosis.