Massin N, Westphal J C, Schrijen F, Polu J M, Sadoul P
Bull Eur Physiopathol Respir. 1979 Sep-Oct;15(5):821-37.
The prognostic value of several functional respiratory and haemodynamic variables was studied in a group of 212 patients with chronic bronchitis, who were examined in steady state, without cardiac or respiratory failure, at rest and when possible during moderate exercise (195 patients). Follow-up interval ranged from 5 to 12 years. Results were processed using two methods: estimation of actuarial survival rate and discriminant analysis. Survival rate curves for the patients showed a reduction relative to the general population of the same ages: 74% within five years compared to 91% in the general population, 56% within nine years compared to 82%. Survival rate was significantly lower in patients with PPA above 30 mmHg, or driving pressure (PPA--PW) above 15 mmHg, or pulmonary vascular resistance higher than 210 dyn . s . cm-5, or when PPA increased more than 10 mmHg during exercise. Discriminant analysis underlined the predictive value of three haemodynamic variables: PPA change from rest to exercise, pressure developed by the right heart (PPA--PRVED) and stroke volume: together, they predict the death of 3 over 4 patients with the criteria chosen.
对212例慢性支气管炎患者的若干呼吸功能和血流动力学变量的预后价值进行了研究。这些患者处于稳定状态,无心脏或呼吸衰竭,在静息状态下以及尽可能在适度运动期间(195例患者)接受了检查。随访间隔为5至12年。结果采用两种方法进行处理:精算生存率估计和判别分析。患者的生存率曲线相对于同年龄段的普通人群有所降低:五年内为74%,而普通人群为91%;九年内为56%,而普通人群为82%。肺动脉平均压(PPA)高于30 mmHg、驱动压(PPA - PW)高于15 mmHg、肺血管阻力高于210 dyn·s·cm⁻⁵或运动期间PPA升高超过10 mmHg的患者,其生存率显著较低。判别分析强调了三个血流动力学变量的预测价值:从静息到运动时的PPA变化、右心产生的压力(PPA - PRVED)和每搏输出量:综合起来,根据所选标准,它们能预测四分之三患者的死亡情况。