急性高原病患者支气管肺泡灌洗前后肺功能及血气的改变  

Changes of pulmonary function and partial oxygen pressure before and after bronchoalveolar lavage in patients with acute high altitude sickness

作　　者：牟信兵[1] 洪青元[1] 罗晓慧[1] 朱素琼[1] 冯玉兰[1] 

机构地区：[1]西藏军区总医院全军高山病防治研究中心,西藏拉萨850003

出　　处：《中国病理生理杂志》2003年第8期1100-1102,共3页Chinese Journal of Pathophysiology

摘　　要：目的 :探讨急性高原反应 (HAAR)及高原肺水肿 (HAPE)的发病机理。方法 :对 10例HAAR患者及 6例HAPE患者灌洗前和灌洗后进行肺功能和动脉血气检测 ,并与 10例高原健康者进行对比。结果 :HAAR患者及HAPE患者灌洗前动脉血氧分压明显低于对照组 ,HAAR同HAPE均存在弥散功能障碍 ;HAPE肺弥散功能 (DLCO % )由灌洗前的 (76 0 1± 6 2 9) % ,上升到灌洗后的 (10 3 31± 9 2 3) % ;气体转化因子 (DLCO/VA % )由灌洗前的 (15 0 30±15 2 0 ) % ,上升到灌洗后的 (176 0 4± 16 10 ) % ;动脉血氧分压 (PaO2 )由 (31 73± 3 0 1)mmHg上升到 (45 31± 3 5 6 )mmHg。而HAAR及对照组灌洗后上述指标差异不显著。结论 :HAPE患者肺泡内大量的液体渗出是HAPE病情恶化的主要原因之一。HAAR属HAPE发展的初级阶段 ,存在着间质性肺水肿。AIM: The purpose of this study was to evaluate the mechanism of high altitude pulmonary edema (HAPE) and high altitude acute response (HAAR). METHODS: Pulmonary function and partial oxygen pressure were measured in 10 patients with HAAR and 6 patients with HAPE before and after bronchoalveolar lavage (BAL),10 high altitude healthy volunteers were served as control subjects. RESULTS: The partial oxygen pressure of HAAR and HAPE significantly decreased before BAL compared with control; DLCO%, DLCO/VA%, PaO_2 of HAPE increased significantly [from 76.01%±6.29%, 150.30%±15.20%, (31.73±3.01) mmHg before BAL to 103.31%±9.23%, 176.04%±16.10%, (45.31±3.56) mmHg after BAL]. The above parameters were also changed in HAAR and controls, but had no statistical significance. CONCLUSION: High concentration of proteins and cells in BAL fluid for HAPE, gas exchange impairment and PaO_2 increase after BAL suggest accumulation of protein-rich fluid and cells in the alveolar space plays a crucial role in the development of HAPE.

关 键 词：支气管肺泡灌洗 缺氧 高原肺水肿 急性高原反应 

分 类 号：R363[医药卫生—病理学]