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对慢性阻塞性肺部疾病(COPD)预后的评价,常取决于肺动脉高压(PAH)是否存在和其程度。目前有许多特殊治疗对PAH是有效的,包括长期氧疗和使用肺血管舒张药。报告93例严重的COPD在未经特殊治疗的情况下随访5～14年(平均8年)的结果。方法:本组COPD标准:用力时明显的呼吸困难;阻塞性者FEV_1/FVC之比<60％和TLC之比>80％预计值;低氧血症指疾病稳定情况时休息的P_αO_2<80mmHg。从第1次至最后1次血液动力学测定的中间间隔≥5年。本组病例除外以下情况:COPD的急性期:显著肥胖;左心疾患:经支气管扩张试验FEV_1增加≥20％;高血压(舒张压>105mmHg):其他慢性肺部
The assessment of the prognosis of chronic obstructive pulmonary disease (COPD) often depends on the presence and extent of pulmonary hypertension (PAH). There are many specific treatments available for PAH, including long-term oxygen therapy and the use of pulmonary vasodilators. 93 cases of severe COPD were followed up for 5 to 14 years (mean 8 years) without special treatment. Methods: This group of COPD criteria: significant forced breathing difficulties; obstructive FEV_1 / FVC ratio <60% and TLC ratio> 80% of the expected value; hypoxemia refers to the rest of the disease stability P_αO_2 <80mmHg. The interval from the first to the last hemodynamic determination was ≥5 years. In this group of patients with the exception of the following: acute phase of COPD: significant obesity; left heart disease: bronchodilator FEV_1 increased ≥ 20%; hypertension (diastolic blood pressure> 105mmHg): other chronic lung