摘要
目的探讨原发性肺动脉高压(PPH)的早期临床诊断和治疗。方法对48例PPH患者的病史、临床表现和各项辅助检查进行回顾性分析。全部患者均进行常规心电图、X线胸片、超声心动图、右心导管及动脉血气分析。结果PPH患者最早的症状为劳累后逐渐发生的呼吸困难,其它症状包括胸痛、晕厥、疲劳、周围性水肿。最常见的体征是肺动脉瓣区第二心音亢进及右心室第四心音奔马律。胸片为肺动脉段明显突出,左右肺动脉粗大,肺野清晰。超声心动图表现为右心室内径扩大,右心室壁肥厚,室间隔矛盾运动,肺动脉明显增宽。心导管检查肺动脉压常增至正常的3倍以上。右心房压力亦升高,但心排血量降低。结论PPH应注重早期诊断和治疗,及早做超声心动图、心导管检查,及早诊断和治疗可延缓病情发展,并可延长生存期。
Objective To discuss the early diagnosis and treatment of primary pulmonary hypertension（PPH） in the clinic. Methods The general history, clinical manifestations and various auxiliary tests of 48 cases of patients with PPH were retrospectively analyzed. All patients underwent electrocardiogram（ ECG）, X-ray, echocardiography, right cardiac catheterization and arterial blood gas analysis. Results The earliest clinical symptom of patients with PPH was the shortness of breath after exertion, and other symptoms included chest pain, syncope, fatigue, peripheral edema. The most common signs were a loud P2 （pulmonic valve closure sound） and S4 gallop of right ventricular. The X-ray of the patients showed that prominence of the pulmonary artery segment, larger pulmonary arteries and clear lung field. Echocardiography showed the expansion of right ventricular diameter, hypertrophy of right ventricular, contradiction of ventricular septal movement and widen of pulmonary artery. Cardiac catheterization found that pulmonary arterial pressure was more than three times of the normal. Right atrial pressure also increased, but cardiac output （CO） was lower. Conclusion PPH patients should be diagnosed and treated as soon as possible, and evaluated with echocardiography and cardiac catheterization, in order to delay the development of disease, and extend survival time.
出处
《国际内科学杂志》
CAS
2008年第7期376-378,382,共4页
International Journal of Internal Medicine
基金
湖南省卫生厅科研基金资助(B2007199)
湖南环境生物职业技术学院院长科研基金资助(Z07-10)
关键词
原发性肺动脉高压
超声心动图
早期临床诊断
预后
Primary pulmonary hypertension
Echocardiography
Early clinical diagnosis
Prognosis
