综合干预治疗尘肺并肺动脉高压患者的临床观察

Clinical observation of patients with pneumoconiosis and pulmonary hypertension after treatment by comprehensive intervention

目的观察综合干预治疗尘肺并肺动脉高压患者的临床效果。方法 60例尘肺合并肺动脉高压患者随机分成对照组、肺泡灌洗组、综合干预组,每组20例。对照组采取对症治疗(吸氧、抗炎、解痉、平喘、祛痰等);肺泡灌洗组,采用对症治疗+生理盐水全肺灌洗;综合干预组,采用对症治疗+丹参药物治疗+低浓度丹参液(每500ml生理盐水加入丹参注射液2ml)全肺灌洗。观察各组患者治疗前、治疗后1个月和治疗后1年的6min步行距离、肺动脉收缩压、生活质量(CAT问卷评分)、动脉血氧饱和度变化。结果三组患者治疗前年龄、病情严重程度差异无统计学意义(P>0.05);在1月后,肺泡灌洗组、综合干预组6分钟步行距离、肺动脉收缩压、CAT问卷评分、血氧饱和度明显改善,差异具有统计学意义(P<0.05),但对照组仅血氧饱和度改善(P<0.05),其他指标无明显改善(P>0.05);1年后,综合干预组6 min步行距离、肺动脉收缩压、CAT问卷评分、血氧饱和度与肺泡灌洗组、对照组比较有显著差异(P<0.05)。结论采用综合干预治疗尘肺并肺动脉高压患者,近期疗效明确。

Objective To observe the clinical effect of the treatment by comprehensive intervention in patients with pneumo- coniosis and pulmonary hypertension. Methods 60 cases of pneumoeoniosis combined with pulmonary hy16ertension were random- ly divided into control group,alveolar lavage group,comprehensive intervention group, 20 cases in each group. The control group take symptomatic treatment （oxygen, anti-inflammatory, antispasmodic, antiasthmatic, expectorant） ; Alveolar lavage group, the treat- ment of symptomatic treatment ＋ saline whole lung lavage;Comprehensive intervention group,the treatment of symptomatic ti＇eat- ment ＋ Salvia miltiorrhiza drug therapy ＋ whole lung lavage with Low concentration of Salvia mihiorrhiza solution （per 500ml of saline added Salvia mihiorrhiza injection 2ml）. 6-minutes walking distance,pulmonary arterial systolic pressure,quality of life （CAT questionnaire score）, and arterial oxygen saturation were observed in the patients before treatment, 1 months and 1 year after treatment. Result There was no significant difference between the three groups in age, the severity of the disease（6-minutes walk- ing distance,pulmonary arterial systolic pressure,CAT score and blood oxygen saturation） before the treatment （P〉0.05）;Afterl 1 months,the 6-minutes walking distance,pulmonary artery systolic pressure,CAT score and blood oxygen saturation ＇were signifi- cantly improved in alveolar lavage group and comprehensive intervention group （P〈0.05）,the control group only blood oxygen satu- ration improved（P〈0.05）, other indexes had no obvious improvement ; 1 years later, Compared with alveolar lavage group and control group there were significant differences with the 6-minutes walking distance,pulmonary arterial systolic pressure, CAT score,blood oxygen saturation （P〈0.05）. Conclusion The short-term effects were obvious in the treatment of pneumoconiosis with pulmonary hypertension by comprehensive intervention.