Marino Kh
Vutr Boles. 1982;21(5):74-81.
One hundred thirty nine patients with acquired valvular defects were examined, 56 of them were studied in dynamics as well as nine healthy subjects. The changes in the functional and true intrapulmonary shunts were studied as well as the alveolar-arterial gradients for O2 in breathing of atmospheric air and 100% O2, the slope of the alveolar plateau of capnogram, etc. The results obtained revealed a considerable reduction of the values of the functional and true intrapulmonary shunts, the alveolar-arterial gradients for O2 and the slope of the alveolar plateau of capnogram after the treatment carried out. In stage I of cardiac insufficiency the values obtained after the treatment are very close to the normal, suggesting the possibility of complete reversibility of the functional disorders established at the initial stage of cardiac insufficiency. The presence of a considerable increase of the shunts and the alveolar-arterial gradients for O2 even before the manifestation of the clinical signs enables the early functional diagnostics in parallel with the changes in diffusibility of lungs, described by us. The dynamic study of those functional studies reveals some of the pathogenetic mechanisms of the disorders in the respiratory system in case of acquired heart defects.
对139例获得性瓣膜缺陷患者进行了检查，其中56例进行了动态研究，还有9名健康受试者。研究了功能性和真性肺内分流的变化，以及在呼吸空气和100%氧气时的肺泡 - 动脉氧梯度、二氧化碳图的肺泡平台斜率等。所获得的结果显示，在进行治疗后，功能性和真性肺内分流的值、肺泡 - 动脉氧梯度以及二氧化碳图的肺泡平台斜率均有显著降低。在心脏功能不全的I期，治疗后获得的值非常接近正常，这表明在心脏功能不全初始阶段所确立的功能障碍有可能完全可逆。甚至在临床症状出现之前，分流和肺泡 - 动脉氧梯度就有显著增加，这使得能够与我们所描述的肺扩散能力变化并行进行早期功能诊断。对这些功能研究的动态研究揭示了获得性心脏缺陷情况下呼吸系统疾病的一些发病机制。
