肺动脉高压对特发性肺纤维化患者生理指标的影响

张惠民1 ，李建英1 ，张莹莹1 , 2 ，李娜苗1, 2

（1.陕西省西安市中心医院呼吸科，陕西 西安，710003；2.延安大学医学院，陕西 延安，716000）

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摘要：

目的 探讨肺动脉高压对特发性肺纤维化患者生理指标的影响。方法 选取我院呼吸内科收治的特发性肺纤维化患者 130例，根据肺动脉收缩压的高低将患者分为肺动脉高压组和非肺动脉高压组，对两组患者的一般资料、静态肺功能指标、 心肺运动试验指标和6 min 步行试验距离进行比较，同时将差异有统计学意义的相关生理指标与肺动脉收缩压进行Pearson 相关分析。结果 130 例特发性肺纤维化患者中肺动脉收缩压≥40 mmHg 的有43 例，占总例数的33.08%；两组患者在年龄、 性别、吸烟、冠状动脉疾病、高血压和激素治疗方面差异不显著（P>0.05），但在NYHA 心功能分级和氧疗方面差异具有统计 学意义（P<0.05）；两组患者FVC、FEV1/FVC、运动功率、摄氧量、氧脉搏、AT/VO2 和休息时的PaCO2水平比较，差异不显著（P> 0.05），但6 -MWD 、休息时SpO2、运动时SpO2、休息时PaO2 和休息时P（A -a）O2 水平比较，差异有统计学意义 （P<0.05）。6-MWD、休息时PaO2 和运动时SpO2与肺动脉收缩压呈负相关（P<0.05），休息时P（A-a）O2与动脉收缩压呈正相关（P<0.05）。结论 肺动脉高压合并特发性肺纤维化患者的运动耐力下降，特发性肺纤维化患者的6-MWD、休息时PaO2、运 动时SpO2 和休息时P（A-a）O2 与肺动脉高压具有明显相关性。

关键词：特发性肺纤维化；肺动脉高压；心肺运动试验

中图分类号：R563.9文献标志码：A文章编号：2096-1413(2017)34-0022-03

Effects of pulmonary hypertension on physiological indexes in patients with idiopathic pulmonary fibrosis
ZHANG Hui-min 1, LI Jian-ying 1, ZHANG Ying-ying 1，2, LI Na-miao 1，2
(1. Respiratory Department, Xi``an Central Hospital, Xi``an 710003; 2. Medicine Academy of Yan``an University, Yan``an 716000, China)

ABSTRACT: Objective To investigate the effect of pulmonary hypertension on physiological indexes in patients with idiopathic pulmonary fibrosis. Methods One hundred and thirty cases of patients with idiopathic pulmonary hypertension in respiratory medicine department of our hospital were selected, and devided into pulmonary hypertension group and non-pulmonary hypertension group according to the discretion of the pulmonary artery systolic pressure. The clinical data, static lung function indexes, cardiopulmonary exercise testing indexes and 6 min walking distance test of patients were compared between the two groups, and significantly related physiological indexes and pulmonary artery systolic pressure were also analyzed by Pearson at the same time. Results Of the 130 patients with idiopathic pulmonary fibrosis, there were 43 patients with pulmonary artery systolic blood pressure ≥40 mmHg, accounting for 33.8% . There was no significant difference between the two groups in age, gengder, smoking, coronary artery disease, hypertension and hormone therapy (P> 0.05). However, there were significant differences in NYHA function classification and oxygen therapy (P<0.05). There was no significant difference in FVC, FEV1/FVC, exercise power, oxygen uptake, oxygen pulse, AT/VO2 and PaCO2 at rest between the two groups (P>0.05); however, there were significant differences in 6 -MWD, SpO2 at rest, SpO2 during exercise, PaO2 at rest and P(A-a)O2 at rest (P<0.05). The 6-MWD, PaO2 at rest and exercise-induced SpO2 were negatively correlated with pulmonary artery systolic pressure (P<0.05). The P (A-a)O2 at rest was positively correlated with arterial systolic pressure (P<0.05). Conclusion The exercise tolerance of patients with pulmonary hypertension complicated with idiopathic pulmonary bibrosis significantly decreases, and 6-MWD, PaO2 at rest, SpO2 during exercise and P(A-a)O2 in patients with idiopathic pulmonary bibrosis are significantly associated with pulmonry hypertension.
KEYWORDS: idiopathic pulmonary fibrosis; pulmonary hypertension; cardiopulmonary test

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