Franz H, Schauer J
Klinik für Innere Medizin, Universität Leipzig.
Z Gesamte Inn Med. 1993 Nov;48(11):538-43.
The evidence of elevated non-invasive parameters in prediction of pulmonary hypertension was examined in 168 patients with chronic obstructive pulmonary disease (COPD). Forced vital capacity (FVC), Tiffeneau-test (FEV1), oxygen partial pressure, x-ray ascertained diameter of right descending branch of pulmonary artery (RDB), myocardial scintigraphy, and right ventricular ejection fraction showed significant differences between patients with and without pulmonary hypertension. Neither of them alone allows prediction of pulmonary pressure exactly, only in combination non-invasive parameters are usable. In non-invasive diagnosis of catheterisation we suggest to use a regression function including FEV1, FVC and RDB by an ascertained specificity of 80% and sensitivity of 75%. To classify the patients according to normal and increased pulmonary artery pressure, FEV1, RDB and myocardial scintigraphy by a discriminant function with specificity/sensitivity of 80%, are relevant parameters. Accurate diagnosis of latent pulmonary hypertension requires right heart catheterisation. The domain of non-invasive diagnosis is screening and therapy monitoring of pulmonary hypertension, or if right heart catheterisation is contraindicated.
在168例慢性阻塞性肺疾病（COPD）患者中，研究了无创参数升高在预测肺动脉高压方面的证据。用力肺活量（FVC）、蒂夫诺试验（FEV1）、氧分压、X线确定的肺动脉右降支（RDB）直径、心肌闪烁显像以及右心室射血分数在有和没有肺动脉高压的患者之间显示出显著差异。它们单独一项都不能准确预测肺动脉压力，只有联合使用无创参数才有用。在无创诊断导管插入术中，我们建议使用一个回归函数，该函数包括FEV1、FVC和RDB，确定的特异性为80%，敏感性为75%。为了根据肺动脉压力正常和升高对患者进行分类，通过特异性/敏感性为80%的判别函数得出的FEV1、RDB和心肌闪烁显像，是相关参数。隐匿性肺动脉高压的准确诊断需要右心导管插入术。无创诊断的领域是肺动脉高压的筛查和治疗监测，或者在右心导管插入术禁忌时使用。
