论文部分内容阅读
慢性肺疾患并肺高压患者12例,年龄44～65岁.按通气功能障碍分为阻塞性5例,限制性2例,混合性5例。无心肌梗塞或肯定的冠状动脉疾病病史。研究期间无心肺疾患的急性发作。稳定期测定常规肺功能。研究前均按习用方法治疗6个月以上,住院期间亦不变。导管检查前及检查当中停止吸氧。插入导管后患者即服肼苯哒嗪25mg,如无副作用,以后每6小时口服50mg,48小时内重复测定血流动力学变化。结果休息时所有患者肺动脉压和肺小动脉阻力增高,肺毛细血管楔压正常。口服肼苯哒嗪后,平均肺动脉压从52降至44mmHg(p<0.01)。肺小动脉阻力从11.2降至6.2 U(p<0.0005)。平均右房压从8降至6mmHg(p<0.05)。平均右室舒张末压从10降至7mmHg(p<0.05)。心排出量从4.3增至6.3L/min(p<0.001)。平均搏出量增加40%。动静脉氧差从8降至6vol%(p<0.001)。运动时平均肺动脉压从68降至59mmHg(p<0.01)。肺动脉总阻力从12.7降至8.9U(p<0.01)。心排出量从6.1增至7.6L/min(p<0.01)。搏出量增加30%。肺动脉氧饱和度从27增至39%(p<0.001)。口服肼苯哒嗪前后肺功能测验没有变化。
Chronic pulmonary disease and pulmonary hypertension in 12 patients, aged 44 to 65. According to ventilatory dysfunction is divided into obstructive 5 cases, 2 cases of restrictive, mixed 5 cases. No history of myocardial infarction or definite coronary artery disease. No acute heart and lung disease episodes during the study. Routine determination of routine lung function. Before the study according to the conventional method of treatment for more than 6 months, hospital stay unchanged. Oxygen was stopped before and during catheter examination. After the catheterization, the patient served 25 mg of hydralazine, and if there was no side effect, 50 mg was given every 6 hours later, and the hemodynamic changes were repeated within 48 hours. Results At rest, all patients had elevated pulmonary arterial pressure and pulmonary arteriolar resistance, and pulmonary capillary wedge pressure was normal. After oral administration of hydralazine, mean pulmonary arterial pressure decreased from 52 to 44 mmHg (p <0.01). Pulmonary arteriolar resistance decreased from 11.2 to 6.2 U (p <0.0005). Mean right atrial pressure dropped from 8 to 6 mmHg (p <0.05). Mean right ventricular end-diastolic pressure decreased from 10 to 7 mmHg (p <0.05). Cardiac output increased from 4.3 to 6.3 L / min (p <0.001). Average stroke volume increased by 40%. Arteriovenous oxygen differential decreased from 8 to 6 vol% (p <0.001). Mean pulmonary artery pressure decreased from 68 to 59 mm Hg during exercise (p <0.01). Total pulmonary artery resistance decreased from 12.7 to 8.9 U (p <0.01). Cardiac output increased from 6.1 to 7.6 L / min (p <0.01). Stroke volume increased by 30%. Pulmonary arterial oxygen saturation increased from 27 to 39% (p <0.001). No changes in pulmonary function tests before and after hydralazine oral administration.