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慢性阻塞性肺疾病(COPD)是发生肺心病的最常见病因,COPD 患者约有50～70%继发肺心病,如能控制发生肺心病的先决条件即肺动脉高压,则可防止肺心病的发生,但目前有关降低肺动脉压的药物疗效尚未完全肯定。本文旨在观察前列腺素 E_1(PGE_1)对 COPD 患者肺动脉高压及右室功能的作用。方法选择22例伴显性肺动脉高压患者参加实验,其中男19例、女3例,平均年龄59±6岁。滴药前先测定运动前、后血液动力学及血气指标作为对照,然后静滴 PGE_1,剂量为0.05～0.1mg/kg/min共20min,再测定运动前、后各指标,进行自身前、后对比。血液动力学测定采用 Swan-Ganz 热稀释导管,主要指标有肺动脉压(PAP)、肺血管阻力(PVR)、心脏指数(CI)、动脉血压(BP)及体循环阻力(SVR)等。另外,对7例患者,注入~(99m)Tc 标记的自身红细胞,进行放射性核素心室造影,计算运动前、后的射血分数(RVEF),以反映左、右心室泵功能。
Chronic obstructive pulmonary disease (COPD) is the most common cause of pulmonary heart disease. About 50-70% of patients with COPD have pulmonary heart disease. Preventing the occurrence of pulmonary heart disease by controlling pulmonary hypertension is a prerequisite for controlling the occurrence of pulmonary heart disease , But the current efficacy of drugs to reduce pulmonary arterial pressure has not yet been fully affirmed. This article aims to observe the effect of prostaglandin E_1 (PGE_1) on pulmonary hypertension and right ventricular function in COPD patients. Methods Twenty-two patients with dominant pulmonary hypertension were enrolled in the study, including 19 males and 3 females, with an average age of 59 ± 6 years. Before dropping, the hemodynamics and blood gas index before and after exercise were measured as control, and then PGE_1 was intravenously administered at a dosage of 0.05 ~ 0.1mg / kg / min for 20min. The indexes before and after exercise were measured before and after exercise Compared. Hemodynamics was performed with Swan-Ganz thermal catheter. The main indexes were pulmonary arterial pressure (PAP), pulmonary vascular resistance (PVR), cardiac index (CI), arterial blood pressure (BP) and systemic circulation resistance (SVR). In addition, 7 patients were infused with 99m Tc-labeled autologous erythrocytes for radionuclide ventriculography and the ejection fraction (RVEF) before and after exercise was calculated to reflect left and right ventricular pump function.