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目的探讨高原健康人和高原病患者肺循环血流动力学变化规律及其与高原病发病的关系。方法采用右心漂浮导管术测定高原健康人及高原病（ＨＡＤ）患者血流动力学参数１１７例，其中高原健康人２７例，急性高原反应（ＡＨＡＲ）６例，慢性高原病（ＣＨＡＤ）３１例，急性高原肺水肿（ＡＨＰＥ）５２例。结果高原健康人肺动脉平均压（ｍＰＡＰ）在正常范围内，ＡＨＡＲ、ＣＨＡＤ、ＡＨＰＥ患者ＭＰＡＰ分别为３．７３±１．４８ｋＰａ（２８．０±１１．１ｍｍＨｇ）、４．３４±１．６８ｋＰａ（３２．６±１２．６ｍｍＨｇ）、６．６５±１．５１ｋＰａ（５０．０±１１．３ｍｍＨｇ），以ＡＨＰＥ的ＭＰＡＰ最高。各型ＨＡＤ患者ＭＰＡＰ与血氧饱和度呈负相关，与肺循环阻力及右室作功指数（ＲＶＳＷＩ）呈正相关，而体循环压力改变不明显。结论认为低氧性肺动脉高压（ＨＰＡＨ）在高原健康人群中无普遍性，ＨＰＡＨ是各型高原病共有的重要病理生理改变，而轻度ＨＰＡＨ是早期高原病的征兆。
Objective To investigate the changes of pulmonary circulation hemodynamics and its relationship with the pathogenesis of altitude sickness in healthy people and plateau patients. Methods Totally 117 patients with plateau healthy people and patients with high altitude sickness (HAD) were enrolled in this study. Among them, 27 cases were healthy people in plateau, 6 cases were acute altitude sickness (AHAR), 31 cases were chronic mountain sickness (CHAD) , Acute high altitude pulmonary edema (AHPE) in 52 cases. Results The mean pulmonary artery pressure (mPAP) of healthy people in plateau was within the normal range. The MPAP of AHAR, CHAD and AHPE were 3.73 ± 1.48kPa (28.0 ± 11.1mmHg) and 4.34 ± 1.68kPa .6 ± 12.6 mmHg), 6.65 ± 1.51 kPa (50.0 ± 11.3 mmHg), with the highest MPAP for AHPE. MPAP in all types of HAD patients was negatively correlated with oxygen saturation, positively correlated with pulmonary resistance and right ventricular work index (RVSWI), but no significant changes in systemic pressure. Conclusions Hypoxic pulmonary hypertension (HPAH) is not common in healthy people at high altitude. HPAH is an important pathophysiological change common to all types of altitude sickness, while mild HPAH is a sign of early altitude sickness.