Vyslouzil Z, Polák J, Widimský J, Suková M
Czech Med. 1980;3(2):123-31.
The pathogenic factors involved in the increase of pressure in the pulmonary artery in 55 tuberculous patients with manifest, and 50 patients with latent pulmonary hypertension were examinated and analyzed in detail. The authors consider decisive the restriction of pulmonary blood bed together with the decrease of functional parenchyma. In the increase of arterial pressure also the functional vasoconstriction participates. An important role plays here hypoxemia adversely affecting the cardiac function. Hypoxemia, of all pathogenic factors, represents the most serious limitation of pulmonary diffusion, though other agents may not be primarily important for the onset and development of pulmonary hypertension. The originating pulmonary hypertension in tuberculosis does not necessitate compensating mechanisms such as polyglobulia, hypervolemia, or increase of the minute cardiac volume normally present in severe and protracted hypoxemia. The prognosis of patients with the mean pulmonary artery pressure higher than 30 mmHg (3.33 kPa) is very bad, the median survival being about 10 months. Contrarily, a low-grade pulmonary hypertension may not, per se, provide sinister prognostic outlooks. Here rather some other agents capable of influencing the perspectives seen to be of major importance.
对55例有明显肺动脉高压的结核患者和50例有潜在肺动脉高压的患者中涉及肺动脉压力升高的致病因素进行了详细检查和分析。作者认为肺血床受限以及功能性实质减少起决定性作用。动脉压升高也有功能性血管收缩的参与。低氧血症在这里起着重要作用，对心脏功能产生不利影响。在所有致病因素中，低氧血症是肺扩散最严重的限制因素，尽管其他因素对肺动脉高压的发生和发展可能并非主要重要因素。结核病中发生的肺动脉高压并不需要像严重和长期低氧血症中通常出现的红细胞增多、血容量过多或心输出量增加等代偿机制。平均肺动脉压高于30 mmHg（3.33 kPa）的患者预后非常差，中位生存期约为10个月。相反，轻度肺动脉高压本身可能不会提供险恶的预后前景。在这里，一些其他能够影响预后的因素似乎更为重要。
