Wang C, Zhang H Y, Weng X Z
Beijing Red Cross Chaoyang Hospital.
Zhonghua Nei Ke Za Zhi. 1991 Aug;30(8):502-5, 522-3.
We studied the pulmonary haemodynamics in 62 cases of chronic cor pulmonale due to chronic obstructive pulmonary disease (COPD). Present criteria for pulmonary hypertension are: pulmonary arterial mean pressure greater than 20 mmHg and/or pulmonary systolic pressure greater than 30 mmHg at rest and pulmonary mean pressure greater than 30 mmHg after exercise. We found that 24 of our 62 cases did not meet these criteria even after exercise despite clinical evidence of cor pulmonale. However, in all cases the pulmonary vascular resistance index (PVRI) was increased (greater than 177 dyn.s.m2.cm-5) and significantly elevated after exercise. It is suggested that 1) it is inappropriate to set the criteria based solely on pulmonary artery pressure to define pathologically increased right ventricular overload; 2) the measurement of PVRI allows the concept of relative and latent pulmonary hypertension to be introduced; 3) PVRI is a more sensitive index of right ventricular overload than pulmonary artery pressures, especially when referring to the result of exercise test.
我们研究了62例由慢性阻塞性肺疾病（COPD）引起的慢性肺源性心脏病患者的肺血流动力学。目前肺动脉高压的诊断标准为：静息时肺动脉平均压大于20 mmHg和/或肺动脉收缩压大于30 mmHg，运动后肺动脉平均压大于30 mmHg。我们发现，在我们的62例患者中，有24例即使在运动后也不符合这些标准，尽管有肺源性心脏病的临床证据。然而，在所有病例中，肺血管阻力指数（PVRI）均升高（大于177 dyn.s.m2.cm-5），且运动后显著升高。提示：1）仅根据肺动脉压力设定标准来定义病理性右心室负荷增加是不合适的；2）PVRI的测量可以引入相对和潜在肺动脉高压的概念；3）PVRI是比肺动脉压力更敏感的右心室负荷指标，尤其是在参考运动试验结果时。
