Strzyzakowska M, Hryniewiecki T, Gutkowski P, Rawczyńska-Englert I
I Kliniki Wad Serca.
Pol Arch Med Wewn. 1995 Jan;93(1):63-8.
The aim of the study was to observe the mechanism of cardiac-airway interaction in patients with rheumatic mitral valve disease. 61 pts with combined mitral disease and 9 with isolated mitral stenosis (42 females, 28 males; mean age 47 y) were studied. They were in NYHA functional class II-IV (36 pts in II, 22 in III, 12 in IV class). Each patient was assessed by clinical, noninvasive cardiological investigation (estimation of left atrium dimension, mitral gradient, mitral area and right ventricular systolic pressure on echocardiographic examination and relative heart volume on fluoroscopy) and lung function studies i.e. spirography, plethysmography, flow-volume curve and histamine provocation test. The bronchial hyperreactivity was found in 20 pts (75% undergoing test-mean PC40 = 0.1474 mg/ml). In 7 pts histamine test was negative. The reversible airway obstruction (after 200 micrograms FNT) was observed in 43 (61%) pts.
In pts with mitral valve disease we observed significant bronchial hyperresponsiveness to histamine and reversible airway obstruction with no correlation between pulmonary function parameters and cardiological status.
本研究的目的是观察风湿性二尖瓣疾病患者心脏与气道相互作用的机制。研究了61例二尖瓣疾病合并患者和9例单纯二尖瓣狭窄患者（42例女性，28例男性；平均年龄47岁）。他们处于纽约心脏协会（NYHA）心功能II-IV级（II级36例，III级22例，IV级12例）。对每位患者进行了临床、无创心脏检查（通过超声心动图检查评估左心房大小、二尖瓣压差、二尖瓣面积和右心室收缩压，通过荧光透视评估相对心脏容积）以及肺功能研究，即肺量计检查、体积描记法、流量-容积曲线和组胺激发试验。发现20例患者存在支气管高反应性（75%接受试验，平均PC40 = 0.1474 mg/ml）。7例患者组胺试验为阴性。43例（61%）患者观察到可逆性气道阻塞（吸入200微克福莫特罗后）。
在二尖瓣疾病患者中，我们观察到对组胺有显著的支气管高反应性和可逆性气道阻塞，肺功能参数与心脏状况之间无相关性。
