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对49例慢阻肺(COPD)和肺心病患者不同发展阶段的血液动力学和血气变化进行比较.结果:COPD常压组、COPD高压组和肺心病组之间其血液动力学和血气有差异,随病情发展,MPAP、TPR、HR、和PaCO_2逐渐增加,Cpa和PaO_2不断下降,CI和SVI无明显变化;COPD高压组与肺心病代偿组间,其血液动力学和血气变化非常接近;而肺心病代偿组与肺心病失代偿组间则有明显差别;在肺心病组28例中MPAP正常或接近正常8例(占28.6%),说明临床上不能凭一次测定MPAP正常就排除肺心病.并提出把肺心病分为:①隐性肺心病(肺心病前期);②早期肺心病(代偿期肺心病);③失代偿期肺心病(包括急性加重期和缓解期).
The hemodynamic and blood gas changes in 49 COPD and pulmonary heart disease patients at different stages of development were compared.Results: There was a significant difference in hemodynamics and blood gas between COPD group, COPD group and pulmonary heart disease group , With the progression of the disease, MPAP, TPR, HR, and PaCO_2 gradually increased, Cpa and PaO_2 continued to decline, CI and SVI no significant change; COPD high-pressure group and pulmonary heart disease compensatory group, the hemodynamic and blood gas changes are very close; The pulmonary heart disease compensation group and pulmonary heart disease decompensation group were significantly different; in the pulmonary heart disease group 28 cases of MPAP normal or near normal in 8 cases (28.6%), indicating that the clinical can not be determined by a normal MPAP ruled out Coronary heart disease and pulmonary heart disease is proposed to be divided into: ① recessive pulmonary heart disease (early pulmonary disease); ② early pulmonary heart disease (decompensated pulmonary heart disease); ③ decompensated pulmonary heart disease (including acute exacerbation and remission) .