摘要
目的 了解慢性混合型高原病 (CMHD)患者的临床特征并探讨其发病机理。方法选择住院的CMHD患者 11例 ,并以居住在相同海拔高度的 11名健康人作为对照组 ,分析了CMHD患者的临床特征及发病特点 ;采用血气分析仪测定了CMHD患者及对照组的动脉血气指标 ;应用超声心动图、心电图仪测量了CMHD患者及对照组的心功能及心脏结构 ;采用右心漂浮导管检测法观测了CMHD患者及对照组的血流动力学参数。结果 CMHD患者外周血红细胞计数、血红蛋白及红细胞压积均明显高于对照组 ,而外周血白细胞总数及分类值与对照组相比无显著性差异 ;患者同对照组相比 ,PaO2 、SaO2 明显降低 ;CMHD患者肺动脉平均压、肺血管阻力、体动脉平均压及外周血管阻力均显著高于对照组 ,而肺楔压及心输出量与对照组相比未见明显变化。吸氧后 ,CMHD患者心率、肺动脉平均压、肺血管阻力均较吸氧前明显下降 ,吸氧对体动脉平均压及心输出量无明显影响。结论CMHD患者存在着严重的低氧血症、红细胞过度增多、肺动脉高压、体动脉高压及心功能不全。
Objective To observe the clinical features of patients with chronic mixed high altitude disease (CMHD) and explore the mechanism of CMHD. Methods Eleven hospitalized patients with CMHD were enrolled and 11 normal volunteers were selected as control group. The clinical features and characteristics of 11 patients with CMHD were analyzed. The cardiac structure and function of CMHD were observed by echocardiography and electrocardiogram. The hemodynamic parameters of patients with CMHD were measured by Swan-Ganz thermistor catheters. Results The red blood cells, hemoglobin and hematocrit of patients with CMHD were significantly increased compared with those of controls, but white cell count was normal in patients with CMHD. The PaO 2 and SaO 2 of patients with CMHD significantly decreased compared with those of controls. The mPAP, PVP, mSAP and TSVR in patients with CMHD were significantly increased compared with those of controls, while CO and PCWP did not change. After inhalation of 50% oxygen, the HR, mPAP and PVR in patients with CMHD were significantly decreased, while mSAP and CO did not change much. Conclusion The clinical features and hemodynamic characteristics of patients with CMHD are serious hypoxia, polycythemia, pulmonary hypertension, systemic hypertension and cardiac insufficiency.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2004年第2期148-150,共3页
Chinese Journal of Cardiology
