清宁口服液治疗老年慢性阻塞性肺疾病肺动脉高压的临床观察

作者	单位
杨荣时	Yang Rongshi, Yang Jing, Zeng Yulan, et al (Deportment of Internal Medicine, Liyuan Hospital, Wuhan (430077
杨静	Yang Rongshi, Yang Jing, Zeng Yulan, et al (Deportment of Internal Medicine, Liyuan Hospital, Wuhan (430077
曾玉兰	Yang Rongshi, Yang Jing, Zeng Yulan, et al (Deportment of Internal Medicine, Liyuan Hospital, Wuhan (430077
王美婵	Yang Rongshi, Yang Jing, Zeng Yulan, et al (Deportment of Internal Medicine, Liyuan Hospital, Wuhan (430077

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中文摘要:

评价清宁口服液治疗老年慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌ－ｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）肺动脉高压的临床疗效。方法：４０例老年ＣＯＰＤ并肺动脉高压（肺阻抗测定肺动脉平均压≥２．６７ｋＰａ）患者随机分为治疗组（清宁口服液每次２０ｍｌ，每日３次，口服３０天）和对照组（除不给予清宁口服液外，其他治疗与治疗组相同）。治疗前后均进行心肺阻抗、血气分析，体循环血压、血浆组织纤溶酶原激活物（ｔＰＡ）及抑制物（ＰＡＩ）测定。结果：治疗组肺动脉平均压（ｒｎＰＡＰ）降低（２３．８０±２．３１）％；心排血量（ＣＯ）、心脏指数（ＣＩ）和心搏量（ＳＶ）增加；血浆ｔＰＡ升高，ＰＡＩ活性下降。以上与对照组比较和用药前后比较均有显著性差异。而体循环血压，动脉血氧分压（ＰａＯ_２）和二氧化碳分压无显著变化（Ｐ＞０．０５）。用药前后ｍＰＡＰ变化量与ｔＰＡ活性变化量呈负相关（ｒ＝－０．５５４），与ＰＡＩ活性正相关（ｒ＝０．６０８，Ｐ＜０．０５）。结论：清宁口服液对肺循环的作用具有一定的选择性，其降低肺动脉高压的作用可能与血浆ｔＰＡ活性升高、ＰＡＩ活性降低有关。

英文摘要:

To evaluate the clinical effect of Qingning Oral Liquid (QNOL) in treating senile chronic obstructive pulmonary disease (COPD) with pulmonary hypertension. Mathods: Forty patients with mean pulmonary artery pressure (mPAP) more than 2.67 kPa (by impedance rheogram) were divided randondy into two groups. Twenty cases of QNOL group treated by conventional therapy with QNOL cases ml three times a day for 30 days and the other 20 cases treated with conventional therapy alone were taken as control group. Impedance cardiogram and pheopneumogram, blood gas analysis, mean systemic arterial pressure (mSAP), plasma tissue plasminogen activator(tPA) and plasminogen a ctivator inhibitor (PAl) activity were examined before and after treatment. Results: After treatment, the mPAP of QNOL group lowered for 23.80±2.31%, the cardiac output, stroke volume and cardiac index of patients were improved, tPA activity elevated and PAI activity decreased. As compared with before treatment and the control group, these changes were significant statistically. The mSAP, PaO2 and PaCO2 were not significantly changed after treatment (P>0.05). The change of mPAP showed negatively correlated with tPA activity (r=-0.554) and opsitively correlated with PAl activity (r=0.608, P<0.05). Conclusions: QNOL has a selective effect on pulmonary hypertension, its mechanism might be correlated to the elevating plasma tPA and the lowering of PAI activity.

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