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[慢性阻塞性肺疾病患者急性肺血管对吸氧的反应的预后价值]

[Prognostic value of acute pulmonary vascular response to oxygen inhalation in patients with chronic obstructive pulmonary disease].

作者信息

Kato K, Okada O, Yoshida Y, Yamamoto T, Yasuda J, Tanabe N, Kuriyama T

机构信息

Department of Chest Medicine, School of Medicine, Chiba University, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Aug;34(8):870-7.

PMID:8965396
Abstract

Seventy-two patients with chronic obstructive pulmonary disease (COPD) underwent right heart catheterization when they were clinically stable and the relationship between length of survival and acute pulmonary vascular response to 100% oxygen inhalation was studied. Oxygen inhalation significantly reduced mean pulmonary arterial pressure (PPA), cardiac index (CI), and pulmonary arteriolar resistance (PAR). The percent change in PAR (% delta PAR) was used as an index of the acute pulmonary vascular response to 100% oxygen inhalation. Each patient was classified as a responder (% delta PAR > or = 15%) or a nonresponder (% delta PAR < 15%). The cumulative survival rates of these two groups were compared. Responders survived significantly longer than did nonresponders (mean survival times were 2571 days and 1432 days, respectively). The two groups did not differ significantly in anthropometic data, pulmonary hemodynamics, or blood gas data measured at base line during air inhalation. However, FEV1 and VC were significantly lower in nonresponders than in responders. The % delta PAR was not significantly related to age, PPA, PAR on air inhalation, FEV1, FEV1%, VC or VC%. We conclude that the pulmonary vascular response to oxygen inhalation (% delta PAR) may be an independent prognostic factor in patients with COPD.

摘要

72例慢性阻塞性肺疾病(COPD)患者在临床病情稳定时接受了右心导管检查,并对其生存时间与吸入100%氧气后急性肺血管反应之间的关系进行了研究。吸氧显著降低了平均肺动脉压(PPA)、心脏指数(CI)和肺小动脉阻力(PAR)。PAR的变化百分比(%ΔPAR)被用作吸入100%氧气后急性肺血管反应的指标。每位患者被分为反应者(%ΔPAR≥15%)或无反应者(%ΔPAR<15%)。比较了这两组患者的累积生存率。反应者的生存时间显著长于无反应者(平均生存时间分别为2571天和1432天)。两组患者在吸入空气时基线测量的人体测量数据、肺血流动力学或血气数据方面无显著差异。然而,无反应者的FEV1和VC显著低于反应者。%ΔPAR与年龄、PPA、吸入空气时的PAR、FEV1、FEV1%、VC或VC%无显著相关性。我们得出结论,吸入氧气后的肺血管反应(%ΔPAR)可能是COPD患者的一个独立预后因素。

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