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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.