Burke C M, Glanville A R, Morris A J, Rubin D, Harvey J A, Theodore J, Robin E D
Division of Respiratory Medicine, Stanford University Medical Center, California.
Thorax. 1987 Feb;42(2):131-5. doi: 10.1136/thx.42.2.131.
Pulmonary mechanical function and gas exchange were studied in 33 patients with advanced pulmonary vascular disease, resulting from primary pulmonary hypertension in 18 cases and from Eisenmenger physiology in 15 cases. Evidence of airway obstruction was found in most patients. In addition, mean total lung capacity (TLC) was only 81.5% of predicted and 27% of our subjects had values of TLC less than one standard deviation below the mean predicted value. The mean value for transfer factor (TLCO) was 71.8% of predicted and appreciable arterial hypoxaemia was present, which was disproportionate to the mild derangements in pulmonary mechanics. Patients with Eisenmenger physiology had significantly lower values of arterial oxygen tension (PaO2) (p less than 0.05) and of maximum mid expiratory flow (p less than 0.05) and significantly higher pulmonary arterial pressure (p less than 0.05) than those with primary pulmonary hypertension, but no other variables were significantly different between the two subpopulations. It is concluded that advanced pulmonary vascular disease in patients with primary pulmonary hypertension and Eisenmenger physiology is associated not only with severe hypoxaemia but also with altered pulmonary mechanical function.
对33例晚期肺血管疾病患者的肺机械功能和气体交换进行了研究，其中18例由原发性肺动脉高压引起，15例由艾森曼格综合征生理状态引起。大多数患者存在气道阻塞的证据。此外，平均总肺容量（TLC）仅为预测值的81.5%，27%的受试者TLC值低于预测平均值一个标准差。转移因子（TLCO）的平均值为预测值的71.8%，存在明显的动脉低氧血症，这与肺机械功能的轻度紊乱不成比例。与原发性肺动脉高压患者相比，艾森曼格综合征生理状态患者的动脉血氧张力（PaO2）值显著降低（p<0.05），最大呼气中期流速显著降低（p<0.05），肺动脉压显著升高（p<0.05），但两个亚组之间的其他变量无显著差异。结论是，原发性肺动脉高压和艾森曼格综合征生理状态患者的晚期肺血管疾病不仅与严重低氧血症有关，而且与肺机械功能改变有关。
