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目的:分析肺动脉球囊扩张成形术(BPA)治疗慢性血栓栓塞性肺动脉高压(CTEPH)的有效性及安全性。方法:回顾性纳入2017年2月至2019年4月在北京朝阳医院进行过至少1次BPA治疗并行肺动脉压力测定,已充分抗凝治疗3个月,不能手术的CTEPH患者38例,其中男12例,女26例,中位年龄58.5(52.5,66.0)岁。采集患者基线资料及每次BPA前的WHO功能分级、6 min步行距离、平均肺动脉压(mPAP)、肺血管阻力(PVR)、N末端B型利钠肽原(NT-proBNP)及超声心动图等指标。结果:38例患者共进行95次BPA治疗。行BPA前mPAP为50(43,56)mmHg(1 mmHg=0.133 kPa),行至少1次BPA后mPAP为41(32,50)mmHg(n P<0.001)。17例患者完成3~5次BPA,mPAP由50(42,55)降至34(28,49)mmHg(n P<0.01)。15例患者的PVR从852(583,1140)dyn·s·cmn -5降至496(406,802) dyn·s·cmn -5(n P<0.01)。BPA前WHO功能分级Ⅰ/Ⅱ级患者13例,Ⅲ/Ⅳ级患者25例,BPA治疗后WHO功能分级Ⅰ/Ⅱ级患者29例,Ⅲ/Ⅳ级患者9例(n P<0.001)。BPA后6 min步行距离从360(290,442)m增加至449(376,505)m(n P<0.05)。肺灌注Meyer评分从0.54(0.53,0.58)降至0.50(0.44,0.58,n P<0.001)。21例患者的NT-proBNP从1 285(606,2 794)ng/L降至472(148,745)ng/L(n P<0.05)。右心室基底内径由术前的54(41,54)mm降至42(34,49)mm(n P<0.001)。6例次发生不良反应,发生率为6.3%(6/95)。n 结论:对于不能行肺动脉血栓内膜剥脱术的CTEPH患者,BPA可有效降低肺动脉压力及肺血管阻力,改善肺灌注及右心功能,且安全性高,是CTEPH较为有效的治疗方法。“,”Objective:To analyze the efficacy and safety of Balloon Pulmonary Angioplasty (BPA) in patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH).Methods:A total of 38 CTEPH patients received at least one BPA treatment between February 2017 and April 2019 were enrolled. World Health Organization functional class(WHO-FC), 6-minute walking distance(6WMD), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance(PVR), N-terminal pro brain natriuretic peptide(NT-proBNP) and echocardiographic indicators were collected at baseline and before each BPA procedure.Results:38 patients received 95 times of BPA [ 2 (1, 4) times per person] totally. MPAP was 50 (43, 56) mmHg(1 mmHg=0.133 kPa) before BPA and 41(32, 50) mmHg after at least one BPA procedure, n P<0.001. MPAP decreased from 50(42, 55) to 34(28, 49) mmHg (n P=0.003) in 17 cases after 3-5 BPA procedures. In 15 cases, PVR decreased from 852(583, 1 140)dyn·s·cmn -5 to 496(406, 802)dyn·s·cmn -5, n P=0.009. Besides, there were 13 patients with WHO Function Class Ⅰ/Ⅱ before BPA, 25 patients with Ⅲ/Ⅳ class before BPA, 29 patients with Ⅰ/Ⅱ class after BPA treatment, and 9 patients with Ⅲ/Ⅳ after BPA treatment, n P<0.001. 6 WMD before and after BPA increased from 360(290, 442)m to 449(376, 505)m,n P=0.015. The Meyer score of lung perfusion scanning got improved, from 0.54(0.53, 0.58) to 0.50(0.44, 0.58), n P<0.001. Among all registered patients, 21 of whom NT-proBNP decreased from 1 285(606, 2 794) to 472(148, 745),n P=0.014. The inner diameter of the right ventricular decreased from 54(41, 54)mm before surgery to 42(34, 49)mm after surgery, n P<0.001. 6(6.3%, 6/95) complications occurred in 95 times of BPA.n Conclusion:For inoperable patients with CTEPH, BPA can significantly improve disease severity, 6 MWD, heart function, decrease mPAP, PVR and improve lung perfusion, which is a safe and effective therapy.