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成人呼吸窘迫综合征(ARDS)的两个重要特征是“非心源性”(或渗出性)肺水肿和肺动脉高压(PAH)。近已注意到,PAH的发生增加了病人死亡的危险。关于PAH与ARDS预后之间的明显相关,原因尚不清楚。右心室(RV)收缩功能不全可继发于慢性阻塞性肺疾病伴有长期存在PAH的病人。动物实验研究证明,RV输出压力的急性增加损害该心室的收缩功能,最后引起RV泵衰竭。后者将限制左心室血流和可能是PAH引起RV扩张的同时,产生内膜下心肌缺血的后果。继发于急性PAH的RV功能不全可进一步影响左心室(LV)功能,继发于PAH的RV容量超负荷常伴室间隔向左推移及LV几何形的变化。
Two important features of adult respiratory distress syndrome (ARDS) are “non-cardiac” (or exudative) pulmonary edema and pulmonary hypertension (PAH). It has recently been noted that the occurrence of PAH increases the risk of patient death. The obvious correlation between the prognosis of PAH and ARDS is unclear. Right ventricular (RV) systolic dysfunction secondary to chronic obstructive pulmonary disease associated with PAH in patients with long-term. Animal studies have shown that an acute increase in RV output pressure impairs the ventricular systolic function and ultimately RV pump failure. The latter will limit left ventricular blood flow and may be PAH caused by RV expansion while producing the consequences of subendocardial ischemia. RV dysfunction secondary to acute PAH may further affect left ventricular (LV) function, RV volume overload secondary to PAH with left ventricular septal shift and LV geometry changes.