摘要
目的探讨高原健康人和高原病患者肺循环血流动力学变化规律及其与高原病发病的关系。方法采用右心漂浮导管术测定高原健康人及高原病（ＨＡＤ）患者血流动力学参数１１７例，其中高原健康人２７例，急性高原反应（ＡＨＡＲ）６例，慢性高原病（ＣＨＡＤ）３１例，急性高原肺水肿（ＡＨＰＥ）５２例。结果高原健康人肺动脉平均压（ｍＰＡＰ）在正常范围内，ＡＨＡＲ、ＣＨＡＤ、ＡＨＰＥ患者ＭＰＡＰ分别为３．７３±１．４８ｋＰａ（２８．０±１１．１ｍｍＨｇ）、４．３４±１．６８ｋＰａ（３２．６±１２．６ｍｍＨｇ）、６．６５±１．５１ｋＰａ（５０．０±１１．３ｍｍＨｇ），以ＡＨＰＥ的ＭＰＡＰ最高。各型ＨＡＤ患者ＭＰＡＰ与血氧饱和度呈负相关，与肺循环阻力及右室作功指数（ＲＶＳＷＩ）呈正相关，而体循环压力改变不明显。结论认为低氧性肺动脉高压（ＨＰＡＨ）在高原健康人群中无普遍性，ＨＰＡＨ是各型高原病共有的重要病理生理改变，而轻度ＨＰＡＨ是早期高原病的征兆。
Objective To investigate the hemodynamic characteristics of subjects living at high altitude (3 658 m) and its relation with the pathgenosis of high altitude disease. Methods The hemodynamic parameters were measured in 117 subjects including healthy adults and patients with high altitude disease with right heart catheterization. They were divided into 4 groups: 27 healthy adults (A); 6 patients with acute high altitude response (B), 31 with chronic high altitude disease (C) and 52 with acute high altitude pulmonary edema (D). Results Mean pulmonary artery pressure (MPAP) of group A was in normal range, while that of group B, C and D was were 3.73±1.48 kPa, 4.34±1.68 kPa and 6.65±1.51 kPa respectively. In patients with all the types of high altitude disease, MPAP was negativly correlated with SaO 2. However, it was positively correlated with PVR and RVSWI. No significant difference was found in systemic pressure. Conclusion Hypoxic pulmonary artery hypertension is not a common feature in healthy population at high altitude, but it may be the general basasis for all the types of high altitude disease and mild degree of hypoxic pulmonary artery hypertension may be a feature of early high altitude disease.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第1期40-42,共3页
Chinese Journal of Internal Medicine
