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- 栗山 喬之
- 千葉大学医学部肺癌研究施設内科
書誌事項
- タイトル別名
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- Clnical Aspects of Precapillary Pulmonary Hypertension.
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抄録
Cor pulmonale is present in 54-64% of patients with respiratory failure (mean PaO<sub>2</sub>: 52-54 Torr) receiving home oxygen therapy in Japan. This may imply that the development of clinical symptoms of cor pulmonale in the course of the disease more strongly reflects far advanced stage than the presence of respiratory failure.<br>In this paper, clinical data from subjects with various forms of precapillary pulmonary hypertension were analysed with respect to correlation between the prognosis and the pulmonary vascular response to various therapeutic modalities such acute administration of oxygen, vasodilator drugs, and surgery. The results were as follows:<br>1) In subjects with COPD, there was a significant correlation between mean pulmonary arterial pressure (PPA) and prognosis. Patients who showed decreased pulmonary vascular resistance (%ΔPVR<-10) after 100% oxygen inhalation had a good prognosis.<br>2) In subjects with sequelae of pulmonary tuberculosis, there was no apparent correlation between the prognosis and %ΔPVR after 100% oxygen inhalation.<br>3) In subjects with both COPD and sequelae of pulmonary tuberculosis, the lowest value of desaturation during sleep was significantly correlated to the PPA during wake.<br>4) Analysis of 232 cases with primary pulmonary hypertension revealed the following prognostic factors: PPA, cardiac output, stroke volume index, pulmonary vascular resistance, mixed venous oxygen tension, right atrial pressure, total bilirubin, and total protein. There was no significant difference in %ΔPVR after acute administration of vasodilator drugs between the patients who died within 3 years and the patients who survived for 3 years.<br>5) In 18 cases with chronic pulmonary thromboembolism, thrombolytic therapy was of benefit in a limited number of patients who suffered on acute attack within one month before the treatment. Thromboendarterectomy markedly improved abnormal pulmonary circulation in cases of major vessel thromboembolism.
収録刊行物
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- 日本胸部疾患学会雑誌
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日本胸部疾患学会雑誌 30 (1), 3-11, 1992
社団法人 日本呼吸器学会