论文部分内容阅读
目的观察氨氯地平对慢性肺心病患者肺动脉压力及血气的影响。方法选择慢性阻塞性肺疾病并慢性肺心病患者２０例，于服用氨氯地平５ｍｇ／ｄ前、２４ｈ及２周时应用脉冲多普勒超声心动图检测肺动脉血流频谱并计算肺动脉压力，同时监测动脉血气变化。结果服药２４ｈ及２周时较服药前肺动脉血流频谱加速度时间明显延长（Ｐ＜０．０１及０．０５），加速度时间与右室射血期比值及与减速度时间比值明显加大（Ｐ均＜０．０５），右室射血前期与加速度时间比值明显减小（Ｐ＜０．０５），肺动脉收缩压（ｍｍＨｇ）由８７±７３分别降至４０±１５及５５±３６，肺动脉舒张压由（ｍｍＨｇ）４０±３５分别降至１７±７及１７±１５，肺动脉平均压由５６±４８分别降至２７±１０及３５±２０（Ｐ均＜０．０５）；动脉血氧分压（ｍｍＨｇ）由６８±１３分别降至６０±１１（Ｐ＜０．０５）及６３±１５（Ｐ＞０．０５），二氧化碳分压及ｐＨ值无明显变化。结论氨氯地平能有效地降低慢性肺心病患者肺动脉高压，长期应用该药使血氧分压下降的副作用较小。
Objective To observe the effect of amlodipine on pulmonary artery pressure and blood gas in patients with chronic cor pulmonale. Methods Twenty patients with chronic obstructive pulmonary disease and chronic cor pulmonale were selected. Pulmonary Doppler echocardiography was performed before and 24 hours and 2 weeks after taking amlodipine 5 mg / d. Arterial blood gas changes. Results The time of acceleration of pulmonary artery blood flow spectrum was significantly prolonged at 24h and 2h after treatment (P <0.01 and 0.05), and the ratio of acceleration time to right ventricular ejection fraction and deceleration time significantly increased (P (P <0.05). The pulmonary arterial systolic pressure (mmHg) decreased from 87 ± 73 to 40 ± 15 and 55 ± 36, respectively. The pulmonary vasodilatation The mean pressure of pulmonary artery decreased from 56 ± 48 to 27 ± 10 and 35 ± 20 respectively (all P <0.05). The arterial partial pressure of oxygen was decreased from 40 ± 35 (mmHg) to 17 ± 7 and 17 ± 15 respectively (MmHg) decreased from 68 ± 13 to 60 ± 11 (P <0.05) and 63 ± 15 (P> 0.05) respectively. There was no significant change in partial pressure of carbon dioxide and pH. Conclusion Amlodipine can effectively reduce pulmonary hypertension in patients with chronic cor pulmonale. The side effect of long-term use of this drug to reduce the partial pressure of blood pressure is small.