摘要
肺动脉高压患者肺一氧化碳传递因子(TL,CO)降低。通过对肺膜扩散能力(Dm)和肺毛细血管血容量(Vc)的研究,确定:1)转移因子各组分对TL、CO的降低的相对贡献;2)原发性肺动脉高压(PPH)与慢性血栓性肺动脉高压(CTEPH)是否存在差异;3)这些参数与血流动力学参数的关系。19例PPH患者和8例CTEPH患者分别检测Dm和Vc。这些病人已被转介考虑进行肺移植。通过心导管检查血流动力学参数。PPH组中,19例患者中有12例Vc降低(平均值+/-SD Vc 72+/-预测值的14%),19例患者中有17例Dm降低(平均值60+/-22% pred)。在CTEPH组中,8例患者中有6例Vc降低,8例患者中有7例Dm降低。平均TL、codm、Vc与PPH组相似。 The reduction in pulmonary membrane diffusion capacity was significantly greater than that in pulmonary capillary blood volume. No differences in pulmonary and cardiovascular functional values were found between the groups. Right atrial pressure showed a significant negative correlation with pulmonary capillary blood volume and an increased pulmonary vascular resistance was associated with a decrease in pulmonary membrane diffusion capacity. These results suggest pronounced functional impairment of the alveolocapillary membrane in these patients.