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本文主要涉及慢性支气管炎和高原缺氧时产生肺循环高压的问题。慢性支气管炎患者肺内虽存在着炎症引起的多种变化,气道阻塞所致的肺泡低氧在升高肺循环压力方面起主要作用。因此,缺氧在慢性支气管炎形成肺心病和高原缺氧形成慢性高原性心脏病中都是重要的。本文着重讨论了缺氧引起肺循环压力升高的机制。目前认为,缺氧时肺内体液因子(儿茶酚胺、组织胺、前列腺素、血管紧张素,5-羟色胺等)的变化和缺氧对肺血管平滑肌的直接作用可能是引起肺动脉压升高的重要因素,植物神经作用很小。但至今尚未找到理想的缺氧时引起肺循环压力升高的体液因子。也缺乏用肺的小血管做缺氧对肺血管平滑肌直接作用的实验。血液酸度对缺氧引起肺循环高压的影响是:酸中毒加强、碱中毒减轻肺循环高压的程度。为便于了解肺循环高压的机制,简述了肺循环的特点及影响肺循环压力的其他因素。
This article mainly relates to chronic bronchitis and hypoxia caused by the issue of pulmonary hypertension. There are many changes in the lungs of patients with chronic bronchitis caused by inflammation, alveolar hypoxia caused by airway obstruction plays a major role in increasing pressure on pulmonary circulation. Therefore, hypoxia is important in the pathogenesis of chronic heart disease due to chronic bronchitis and pulmonary hypoxia. This article focuses on hypoxia-induced pulmonary hypertension mechanism. It is currently believed that the changes of pulmonary factors (catecholamines, histamine, prostaglandins, angiotensin, serotonin, etc.) and the direct effects of hypoxia on pulmonary vascular smooth muscle during hypoxia may be important factors that cause pulmonary hypertension , Autonomic effect is small. But so far no ideal humoral factors have been found to cause an increase in pulmonary circulation pressure during hypoxia. Also lack of lung small blood vessels to hypoxia on pulmonary vascular smooth muscle direct effect of the experiment. Blood acidity on hypoxia caused by pulmonary hypertension is: increased acidosis, alkalosis reduce the degree of pulmonary hypertension. In order to understand the mechanism of pulmonary hypertension, the characteristics of pulmonary circulation and other factors that affect the pressure of pulmonary circulation are briefly described.