中西医结合综合治疗方案对肺心病急性发作期疗效观察及对肺动脉压影响的临床研究
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摘要
目的:
以肺心病发病的重要环节肺动脉高压为研究切入点,制订一个优于目前国内单纯西医及中西医结合治疗方案的,适合中国国情的中西医结合对肺心病急性发作期的综合治疗方案,达到提高临床疗效的目的。
方法:
(1)回顾中医典籍有关肺心病的记载,总结近20年现代中医学家对肺心病的研究。
(2)对现代医学慢性阻塞性肺病所致肺动脉高压的发病机制及临床研究进展进行综述。
(3)系统总结导师陈绍宏教授中西医结合治疗肺心病急性发作期临床经验。
(4)采用前瞻性、多中心、随机、对照、平行临床试验的方法,将66例肺心病急性发作期患者随机分为治疗组(中西医综合治疗方案组)和对照组(西医综合治疗组)。治疗组在常规西医综合治疗方案(除降低肺动脉压药物)的基础上,以宣肺平喘,化痰止咳法为主,脾气亏虚者兼以健脾益肺,阳虚水泛者兼以温阳利水,辨证后口服中药复方煎剂(协定处方1、2或3)。评价两组病人14天病死率,以及综合疗效、主要症状、次要症状、体征、自我生活能力评定,以及两组PAPs等方面的恢复情况。结果:
(1)祖国医学虽未有肺心病之病名,但对本病从症状、病因病机,到治法方药、预后转归均有丰富的论述。现代中医对肺心病的治疗取得了一定的成绩,但研究多集中在一方一法上,且无统一认识。
(2)慢性阻塞性肺病所致肺动脉高压发生机制复杂,单纯西医治疗有限。目前用于肺动脉高压的扩血管药物除NO具有选择性肺血管扩张作用外,其余药物均为非选择性的,而NO又是一种对机体有害的气体。
(3)肺心病急性发作期主要病因病机为痰浊蕴肺、肺气闭郁,治疗应以宣肺平喘,化痰止咳法为主,脾气亏虚者兼以健脾益肺,阳虚水泛者兼以温阳利水。
(4)两组14天病死率无明显差异,治疗组在综合疗效评定、主要症状、次要
Objective:To provide an integrated Traditional Chinese and Western Medicine treatmentprogram for the acute onset period of chronic pulmonary heart disease(CPHD),study the effect of the program on the acute onset period of CPHD. This program isbetter than pure Western medicine program and other plans which combination ofChinese medicine and Western medicine at the present time. It not only suitssituation in our country , but also can raise the clinical curative effect.Methods:(l)Reviewing TCM ancient works about CPHD and summarizing the TCMachievements of the CPHD in the latest twenty years.(2)Generalizing the onset mechanism and clinical researches progress of PAH whichdue to chronic obstructive pulmonary disease(COPD).(3)Systematically summarizing the clinical experience on acute onset of CPHD ofProfessor Chen Shaohong.(4)With prospective multi center randomized controlled trial, 66 patients with acuteonset CPHD were randomized divided in two groups. One is the control group andthe other is the cure group. Both groups were treated with Western medicine therapyexcept the anti-pulmonary-hypertensive drugs. In additional, the patients in the curegroup were treated with decoction 1 or 2 or 3, which based on differentiation.Analysed the 14 days fatality rate, the curative effect, the Pulmonary arteria systolicpressure (PAPs), and the symptom, the sign etc.Results:(l)The CPHD is one of a diseases of Western medicine, but there were abundance ofrecords about it in TCM ancient books. Although a great progress was achieved bythe modern TCM doctors on the study of CPHD, yet most of the research was abouta herb , a decoction ,or a therapeutic method. Otherwise ,the understanding of thedisease CPHD is not having been unified in TCM.(2)The mechanism of PAH because of COPD is complexity, only western medicinetherapy can not get satisfactory curative effect. All anti-pulmonary-hypertensivedrug except NO is not-selective-drugs which not only can reduce the pulmonaryartery pressure , but also systemic circulation. In addition NO is a toxic drug.
以肺心病发病的重要环节肺动脉高压为研究切入点,制订一个优于目前国内单纯西医及中西医结合治疗方案的,适合中国国情的中西医结合对肺心病急性发作期的综合治疗方案,达到提高临床疗效的目的。
方法:
(1)回顾中医典籍有关肺心病的记载,总结近20年现代中医学家对肺心病的研究。
(2)对现代医学慢性阻塞性肺病所致肺动脉高压的发病机制及临床研究进展进行综述。
(3)系统总结导师陈绍宏教授中西医结合治疗肺心病急性发作期临床经验。
(4)采用前瞻性、多中心、随机、对照、平行临床试验的方法,将66例肺心病急性发作期患者随机分为治疗组(中西医综合治疗方案组)和对照组(西医综合治疗组)。治疗组在常规西医综合治疗方案(除降低肺动脉压药物)的基础上,以宣肺平喘,化痰止咳法为主,脾气亏虚者兼以健脾益肺,阳虚水泛者兼以温阳利水,辨证后口服中药复方煎剂(协定处方1、2或3)。评价两组病人14天病死率,以及综合疗效、主要症状、次要症状、体征、自我生活能力评定,以及两组PAPs等方面的恢复情况。结果:
(1)祖国医学虽未有肺心病之病名,但对本病从症状、病因病机,到治法方药、预后转归均有丰富的论述。现代中医对肺心病的治疗取得了一定的成绩,但研究多集中在一方一法上,且无统一认识。
(2)慢性阻塞性肺病所致肺动脉高压发生机制复杂,单纯西医治疗有限。目前用于肺动脉高压的扩血管药物除NO具有选择性肺血管扩张作用外,其余药物均为非选择性的,而NO又是一种对机体有害的气体。
(3)肺心病急性发作期主要病因病机为痰浊蕴肺、肺气闭郁,治疗应以宣肺平喘,化痰止咳法为主,脾气亏虚者兼以健脾益肺,阳虚水泛者兼以温阳利水。
(4)两组14天病死率无明显差异,治疗组在综合疗效评定、主要症状、次要
Objective:To provide an integrated Traditional Chinese and Western Medicine treatmentprogram for the acute onset period of chronic pulmonary heart disease(CPHD),study the effect of the program on the acute onset period of CPHD. This program isbetter than pure Western medicine program and other plans which combination ofChinese medicine and Western medicine at the present time. It not only suitssituation in our country , but also can raise the clinical curative effect.Methods:(l)Reviewing TCM ancient works about CPHD and summarizing the TCMachievements of the CPHD in the latest twenty years.(2)Generalizing the onset mechanism and clinical researches progress of PAH whichdue to chronic obstructive pulmonary disease(COPD).(3)Systematically summarizing the clinical experience on acute onset of CPHD ofProfessor Chen Shaohong.(4)With prospective multi center randomized controlled trial, 66 patients with acuteonset CPHD were randomized divided in two groups. One is the control group andthe other is the cure group. Both groups were treated with Western medicine therapyexcept the anti-pulmonary-hypertensive drugs. In additional, the patients in the curegroup were treated with decoction 1 or 2 or 3, which based on differentiation.Analysed the 14 days fatality rate, the curative effect, the Pulmonary arteria systolicpressure (PAPs), and the symptom, the sign etc.Results:(l)The CPHD is one of a diseases of Western medicine, but there were abundance ofrecords about it in TCM ancient books. Although a great progress was achieved bythe modern TCM doctors on the study of CPHD, yet most of the research was abouta herb , a decoction ,or a therapeutic method. Otherwise ,the understanding of thedisease CPHD is not having been unified in TCM.(2)The mechanism of PAH because of COPD is complexity, only western medicinetherapy can not get satisfactory curative effect. All anti-pulmonary-hypertensivedrug except NO is not-selective-drugs which not only can reduce the pulmonaryartery pressure , but also systemic circulation. In addition NO is a toxic drug.
引文
1.程显声,李景周,张珍祥,等.慢性阻塞性肺疾病、肺心病人群防治的研究基线资料分析.中华结核和呼吸病杂志,1998;21(12):749-752
2.钱桂生.吴国明主编.肺心病的诊断与治疗.北京:人民军医出版设,1999.9
3.蔡如升主编.慢性肺心病20年防治研究.北京:科学技术文献出版社,1994.12
4.程显声.肺心病防治研究进展和策略变化.中华内科杂志,1996;35(11):723-724
5.熊旭东.肺心病肺动脉高压的中西医研究热点.中国中医急症,2000;9(4):174-175
6.崔庆荣,何天有,郭月季,等.中医药治疗肺心病述评.甘肃中医学院学报,2004;21(2):47-50
7.晁恩祥.慢性肺心病急性期286例疗效分析.天津中医,1985;2(1):1-3
8.蔡灿林.洪广祥治疗肺胀的经验.江西中医药,1994;25(2):4-5
9.徐旭东.中西医结合治疗肺心病急性发作64例.四川中医,1996;14(7):22
10.杨林,周若梅.肺胀虚实辨析.陕西中医,1995;16(4):163-164
11.杨明均.慢性肺心病急性发作期81例(85例次)卫气营血辨证分型及防治的探讨.辽宁中医杂志,1982;(1):17-21
12.高洪春.周次清教授诊治慢性肺心病的经验.辽宁中医杂志,1992;19(3):1-3
13.刘振永.中西医结合治疗慢性肺心病急性发作期疗效观察.天津中医,1995;12(3):3-5
14.赵子敏.汪达成治疗肺心病的临床经验.陕西中医学院学报,1994;(4):18-19
15.李若钧.肺胀伏邪的演化规律和特点.山西中医,1994;10(2):3-4
16.刘立东.中医为主治疗肺心病35例疗效观察.湖南中医杂志,1992;8(5):22-23
17.韩树人.肺胀治疗体会.南京中医药大学学报,1995;11(3):19-20
18.黄建庄.肺胀的诊治体会.中原医刊,1995;22(9):22
19.董锡安.中药为主治疗肺心病42例.陕西中医,1992;13(3):101
20.李帮阔.肺胀病辨治点滴.湖北中医杂志,1995;(1):39
21.吴德芸.治疗肺原性心脏病68例临床观察.上海中医药杂志,1994;(7):22-23
22.刘文昭,杨润平.肺心灵治疗慢性肺原性心脏病急性发作期30例临床观察.中医杂志,1992;(10):26-28
23.牛振华,张东有.补阳还五汤治疗肺心病92例.陕西中医,1993;14(11):483
24.吴明华.中西医结合治疗慢性肺源性心脏病急性加重期141例.实用中医药杂志,1996;(2):24-25
25.沈安明.补肺活血汤治疗肺心病46例.安徽中医学院学报,1995;14(1):31
26.王绵丽.润肺化痰法治疗肺心病合并感染50例.陕西中医,1993;14(11):484
27.韩春生.张洪春.活血化瘀治疗肺心病研究近况.黑龙江中医药,1996;(1):54-57
28.陶凯,周晓园,林慧鹃,等.菖蒲雾化剂治疗慢性呼吸衰竭失代偿期临床研究.中医杂志,1996;37(3):161-164
29.宋康.涤痰通腑祛瘀法治疗肺性脑病35例观察.中医杂志,1994;(6):347—348
30.罗本清.吴桂华.肺性脑病的中医辨证治疗探讨.实用中医药杂志,1995;(1):27-29
31.樊亚巍.开闭固脱法在肺性脑病中的应用.实用中医药杂志,1993;(1):11-12
32.单书健,陈小华.古今名医临证金鉴.咳喘肺胀卷(下).北京:中国中医药出版社,1999.8
33.郭振球.肺胀之证治学研究.实用中医药杂志,1994;(6):3-4
34.火树华,赵琨,罗幼琼.慢性肺心病急性发作期中西医结合辨证分型论治的疗效分析.新疆中医药,1986;(2):24-27
35.喻平瀛.慢性肺心病急性发作期按热病论治探讨.南京中医药大学学报,1995;11(4):21-22
36.邓若文,周福生.中西医结合治疗31例肺心病.新中医,1982;(5):20-22
37.段利民.提高中医药治疗肺原性心脏病的疗效管见.河北中医,1994;16(1):3
38.李立.肺心病急性发作期从气论治五法.临床荟萃,1995;10(8):361-362
39.周衡.支饮韧探.河南中医,1982;(2):11-12
40.李若钧.肺胀血瘀证临床论治体会.山西中医.1995;11(6):49-50
41.李文辉.肺胀与血瘀浅探.湖南中医杂志.1994;10(4):27-28
42.周仲瑛.慢性肺源性心脏病的辨治要点.中医杂志,1990;31(1):23-25
43.方邦江,占鸽.宽胸理肺汤治疗慢性肺心病64例.陕西中医.1994;15(4):150
44.张宗铭,陈怀珍,伍丽华.肺心平分型论治肺心病急发期80例.中国中医急症,1996;5(2):56-58
45.王洋.中西医结合治疗肺心病呼吸衰竭21例小结.山西中医,1994;10(2):23-24
46.张素英.中西医结合治疗肺心病急性肺感染疗效观察.天津中医,1995;12(4):5-6
47.付振伟.养阴化痰治疗肺心病.吉林中医药,1995;(5):12
48.李建生,李素云主编.常见老年呼吸系统疾病现代治疗.北京:中国中医药出版社,1996.
49.马全然.清熱祛痰化瘀开窍法治疗肺性脑病的临床观察.天津中医,1996;13(5):18-19
50.高昌杰.中西医结合治疗肺性脑病30例临床分析.实用中医药杂志,1996;(4):23—24
51.曹兴亚.活血化瘀、温阳利水法治疗慢性肺原性心脏病心力衰竭的临床观察.中西医结合杂志,1984;4(10):589
52.刘进才.温阳利水、活血化瘀法治疗肺心病心衰66例.陕西中医.2000,21;(4):147
53.王立军,张雅丽,韩桂芝.消喘散治疗慢性呼吸衰竭临床观察.黑龙江中医药,1996;(2):8-10
54.林群莲,黄发盛.通腑法治疗肺心病急性发作期.实用中西医结合杂志,1996;9(10):621
55.谷元奎,马西文,自拟“通腑泻浊定喘汤”佐治慢性肺心病急性发作31例.临沂医专学报.2000,22;(2):128-129
56.李国贤.通里攻下、活血化瘀法治疗肺心病的疗效观察.江西中医药,1981;(4):12-13
57.魏汉林,杜怀裳.麻杏二三汤治疗肺心病急性发作期250例.中医杂志.1997;38(2):87-88
58.陆德海,段景文,姜光明.加味黛蛤散治疗慢性肺心病急性发作期60例.陕西中医,1995;16(10):435
59.张问渠,张昱主编.老年病中医治疗学.北京:科学技术文献出版社,2000.8
60.洪用森等.水蛭粉用于肺心病.浙江中医杂志,1982;17(3):101
61.袁长瑞,刘秀芬,李成云.中药灌肠治疗肺心病心功能不全的疗效观察.内蒙古中医药,1995;14(3):8-9
62.张水源.参附合川芎嗪注射液治疗肺心病急性发作期的临床观察.中国中西医结合杂志.2002,21;(8):628
63.王学东主编.慢性阻塞性肺疾病中医治疗.南京:江苏科学技术出版社,2002.6.
64.范济平.针刺加穴位贴药治疗慢性支气管炎759例.云南中医杂志,1989;(2):31
65.冯维斌,刘伟胜主编.呼吸科专病.中医临床诊治.北京:人民卫生出版社,2000.9
66.李笑宏,林建海,焦文健.虎杖对缺氧性肺动脉高压动物血流动力学作用的研究.宁夏医学杂志,2001;23(9):515-517
67.刘雪峰,刘青.中医药防治慢性缺氧性肺动脉高压研究进展.中国中医急症,2003;12(5):462-463
68.席思川,阮英卯,张连庄,等.前胡对大鼠缺氧性肺动脉高压逆转效应的实验观察.中国中西医结合杂志,1996;16(4):218-220
69.刘元.辨证治疗肺心病心力衰竭的经验.江西中医药,1994,25(5):23-24
70.段利民.提高中医药治疗肺源性心脏病的疗效管见,河北中医,1994;16(1):3
71.王铁生,段生福,汤秦秦.慢性阻塞性肺病患者的血液流变学改变.中华结核和呼吸杂 志,1989;12(4):228-229
72.陈文彬,颜浩,莫晓能.汉防己甲素对慢性低氧性肺动脉高压大鼠肺内bFGF表达的影响.华西医科大学学报,2001;32(1):12-14
73.康健,于润江,王怀良,等.汉防己甲素降低慢性阻塞性肺疾病肺动脉高压的临床观察.中华结核和呼吸杂志,1993;16(2):93-94
74.岳淼,韩玉永.生水蛭胶囊降低慢性肺源性心脏病血液粘滞度的临床观察.河北中医,1998;20(3):181
75.张守华,赵安芝.中药葛根素对肺心病患者血流动力学的影响,黑龙江中医药,1999;113(3):4-5
76.刘明等主编.呼吸病诊疗全书.北京:中国医药科技出版社,1999,257
77.王学东.慢性阻塞性肺疾病的中医治疗.江苏:江苏科学技术出版社,2002:66-67;92
78.孙琼,张宝陵,孙立勤.黄芪注射液治疗肺心病心衰42例.中国中医急症,1998;7(5):206
79.沈映君.中药药理学.上海:上海科学技术出版社,1997.42-46;68
80.周德奇,王辉.慢性肺心病急性发作期中医药临床治疗研究进展.现代中西医结合杂志,2004;13(13):1804-1807
81.谢灿茂.呼吸系统疾病.北京:科学技术文献出版社,2000.226
82.熊旭东.肺心病肺动脉高压的中西医研究热点.中国中医急症,2000;9(4):174-175
83.蔡柏蔷主编.21世纪医师丛书-呼吸内科分册.北京:中国协和医科大学出版社,2000.477
84. Rihacek I, Soucek M,Toman J. Primary pulmonary hypertension.Vnitr Lek. 1993, Jun;39(6):591-596
85. Incalzi RA,Fuso L,De Rosa M,et al,Electrocardiographic signs of chronic cor pulmonale:A negative Prognostic finding in chronic obstructive Pulmonary disease.Circulation, 1999;Mar 30;99(I 2): 1600-1605
86.尹黎波.继发性肺动脉高压诊断的一些进展.华西医学,1996;11(4):423-426
87,王国干.肺源性心脏病及肺动脉高压的无创性诊断.中国医刊,2000;35(11):5-7
88.邹霞英,辛达临,丁力.慢性阻塞性肺病自然病程与肺动脉压关系.中华结核和呼吸杂志,1988;11(5):271-274
89. The National Emphysema Treatment Trial Research GrouP. Rationale and design or the National Emphysema Treatment Trial: a prospective randomized trial of lung volume reduction surgery. Chest, 1999, 116(6): 1750-1761
90. Oswald-Mammosser M, Weitzenblum E, Quoix E, et al. Prognostic factors in COPD patients receiving long-term oxygen therapy.Importance of pulmonary artery pressure.Chest, 1995,May; 107(5): 1193-1198
91.李海潮.肺源性心脏病的治疗—慢性阻塞性肺病所致肺动脉高压和肺心病的治疗.中国医刊,2000;35(11):10-12
92. Tuder, Rubin M, Voelke NF, et al. Pulmonary hypertension and inflammation. J. Laboratory & Clinical Medicine,1998,Jul 132(1):16-24
93. Voelkel NF, Tuder RM. Cellular and molecular mechanisms in the pathogenesis of severe pulmonary hypertension. Eur Respir J 1995; Dee; 8(12): 2129-2138
94. Arcasoy SM,Christie JD, Ferrari VA,et al.Eehoeardiographie assessment of Pulmonary hypertension in Patients with advanced lung disease.Am J Respir Crit Care Med,2003,Mar,1; 167(5):735—740.
95. Maloney JP. Advances in the treatment of secondary pulmonary hypertension.Curr Opin Pulm Med,2003,Mar; 9(2): 139-143.
96. Sharma S. Treatment of pulmonary arterial hypertension:a step forward. Chest,2003,Jul; 124(1):8-11.
97.王虹,王祥.肺源性肺动脉高压研究进展.江苏医药杂志,2004;30(9)690-692
98.薛全福,谢剑鸣,胡长贵,等.常压缺氧性大鼠肺动脉高压模型的建立.中华结核和呼吸杂志,1989;12(6):350-352
99. Kourembanas S,Moria T, Liu Y, et al. Mechanisms by which oxygen regulates gene expression and cell-cell interaction in the vasculature. Kidney Int, 1997,Feb;51 (2):438-443
100.刘新民,刘秉锟.慢性肺疾病所致肺动脉高压和肺心病发生机制.中国医刊,2000;35(11):4-5
101.李智,王颖,鄂妹玉.肺动脉高压大鼠肺动脉平滑肌细胞1,4,5—三磷酸肌醇受体表达的变化.中国危重病急救医学,2001;13(12):721-723
102. Michelakis ED,Weir EK. The pathobiology of pulmonary hypertension:Smooth muscle cells and ion channels. Ctin Chest Med,2001,Sep;22(3):419-432
103.肖欣荣.陈文彬.钾离子通道活性与缺氧性肺动脉高压.中华内科杂志,1996;35(6):416-418
104. Smimov SV, Robertson TP, Ward JP, et al. Chronic hypoxia is associated with reduced delayed rectifier K~+ current in rat pulmonary artery muscle cells. Am J Physiol,1994, Jan;266(1 Pt 2):H365-370
105.刘琰,徐永健,张珍祥,等.蛋白激酶C激活剂对缺氧性肺动脉高压大鼠离体肺动脉环反应性的影响.中华结核和呼吸杂志,1999;22(2):92-94
106. Xu Y, Stenmark KR, Das M, et al. Pulmonary artery smooth muscle cells from chronically hypoxic neonatal calves retain fetal-like and acquire new growth properties.Am J Physiol ,1997,273(1 Pt 1):L234-245
107. Suzuma K,Takahara N,Suzuma I,et al. Characterization of protein kinase C beta isoform's action on retinoblastoma protein phosphorylation, vascular endothelial growth factor-induced endothelial cell proliferation, and retinal neovascularization. Proc Natl Acad Sci USA, 2002,Jan 22;99(2):721-726
108.冉丕鑫,钟南山.低氧性肺动脉高压发病机理与防治研究现状.现代临床医学生物工程学杂志,1997;3(3):151-154
109. Eddahibi S, Humhert M, Fadal E, et al. Serotonin transporter overexpression is responsible for pulmonary artery smooth muscle hyperptasia In primary pulmonary hypertension. J Clin Invest,2001,Oct; 108(8): 1141-1150.
110.王笑歌,安凤芹,列继华,等.肺心病患者血浆心钠素和肾素-血管紧张素-醛固酮系统的研究.临床内科学,1996,13(4):32-33
111.李恒让.慢性阻塞性肺疾病肺动脉高压的研究现状.临床荟萃,1997;(11):483
112.修相成,李中珂,于普明.肺源性心脏病发病机制及治疗新观念.中国乡村医药,2001;8(5):36-37
113.Hyman Al,Mathe AA,Lippton HL, et al Prostaglandins and the lung.Med Clin North Am,1981 Jul:65(4),789-808
114.宋勇.内皮素、血栓素A_2与肺动脉高压.临床荟萃,1999:14(14):659-661
115.杨和平,吴善,陈云远等.血栓素A2和前列环素与肺心病肺动脉高压关系的探讨.中华内科杂志,1991;30(2):102-103
116.刘芳.COPD并发肺动脉高压的研究进展.国外医学呼吸系统分册,2003;23(4):173-179
117.范蓉,杨万里,漆自立.老年肺心病患者内皮素的检测.中国老年医学杂志,1997;17(6):369-370
118. SuY, Block ER.Role of calpain in hypoxic inhibition of nitric oxide synthase activity in pulmonary endothelial cells.AM J Physiol Lung Cell Mol Physiol,2000;jun;278(6):L1204-1212
119. Giaid A.Nitric oxide and endothelin-1 in pulmonary hypertension. Chest, 1998;Sep;114(3 Suppl):208S-212S
120. Emsley AM,Jeremy JY, Gomes GN, etal.Investigation of the inhibitory effects of homocysteine and copper on nitric oxide-mediated relaxation of rat isolated aorta.Br J Pharmacol, 1999;Feb; 126(4): 1034-1040
121.刘雅.孙培宗,欧阳松云,等.内源性一氧化碳与低氧性肺动脉高压关系的临床研究.中华结核和呼吸杂志,2002;25(9):546-549
122. Wang R,wang Z,Wu L.Carbon monoxide induced vasorelaxation and the underlying mechanisms.Br J Pharmacol,1997,Jul;121(5):927-934
123. Maines MD.The heme oxygenase system: a regulator of second messenger gases.Annu Rev Pharmacol Toxicol, 1997,37:517-554
124. Morita T, Kourembanas S.Endothelial cell expression of vasoconstrictors and growth factors is regulated by smooth muscle cell-derived carbon monoxide.J Clin Invest, 1995,Dec;96(6):2676-2682
125.许军阳,武志杰,潘卫斌.慢性肺心病患者氧自由基和前列腺素代谢的变化.中华内科杂志,1993;10:698
126. Lang RE,Thdken H,Ganten D,et al.Atrial natriuretic factor:a circulating hormone stimulated by volume loading .Nature, 1985,Mar.21-27:314:264-266
127. Comini L,Agnoletti G, Panzali A,et al. Activation of ANP synthesis during congestive heart failure in rats treated with monocrotaline.Am J Physiol,1995,268(1 pt 2):H391-H398
128. Akimoto K, Miyata A, Hayakawa k, et al.Plasma and atrial levels of atrial natriuretic peptide(ANP) in pulmonary hypertensive rats, Life sci, 1988,43 (14): 1125-1132
129.徐金升,丁翠敏,孙志学.内皮素、心钠素与肺心病.国外医学呼吸系统分册.1998;18(2):108-111
130. Pedram A, Razandi M,Levin ER.Natriuretic peptides suppress vascular endothelial cell growth factor signaling to angiogenesis.Endocrinology,2001; 142(4): 1578-1586
131. Martinez A,Miller MJ,Unsworth EJ,et al.Expression of adrenomedullin in normal human lung and in pulmonary tumors Endocrinology, 1995.136(9):4099-4105
132.徐平,戴爱国,周厚德,等.低氧性肺动脉高压大鼠肺内肾上腺髓质素及受体表达研究.中华结核和呼吸杂志,2002;25(8):465-469
133.孙立红,于文成,王兵,等.肾上腺體质素c-型利钠肽神经肽Y与缺氧性肺动脉高压的关系研究,心肺血管病杂志2004;23(4):203-205
134. Saadjian AY, Paganelli F, Ganbert ML,el al Adenosine plasma concentration in pulmonary hypertension.Cardiovasc Res, 1999,43:228-236
135.钟小宁,许辉.低氧性肺动脉高压发病机制及治疗研究进展.医学综述,1998;4(10):541-543
136.叶任高主编.内科学.北京:人民卫生出版社,2001.23
137.卢传义,王迪浔.不同食用油对大鼠肺血管反应性和慢性低氧性肺动脉高压的影响.中国病理生理杂志,1992;8(3):234-237
138. Morganroth ML. Decreased pulmonary vascular responsiveness in rats raised on an essential fatty acid deficient diet. Prostaglandins, 1987,33(2): 181-197
139. Archer SL. Effect of dietary fish oil on lung lipid profile and hypoxic pulmonary hypertension. J Appl Physiol, 1989,66(4): 1662-1673
140.卢传义,王迪浔.饮洒和饮茶对狗低氧性肺血管收缩反应的影响-前列腺素、白三烯的作用.中国病理生理学杂志,1993;9(2):296-298
141. Olschewski H,Rose F, Gruenig E, et al. Cellular pathophysiology and therapy of pulmonary hypertension. J Lab Clin Med,2001,138(6):367-377
142. Adatia I. Recent advances in pulmonary vascular disease. Curt Opin Pediatr,2002,14(3):292-297
143. Andoh Y, Shimura S,Aikawa T, et al. Perivascular fibrosis of muscular pulmonary arteries in chronic obstructive pulmonary disease. Chest, 1992,102:1645-1650
144. Folkman J, Klagsbrun M. Angiogenic factors. Science. 1987, Jan 23;235(4787): 442-447
145. Tuder RM,Flook BE, Voelkel NF Increased gene expression for VEGF and the VEGF receptors KDR/Flk and Flt in lungs exposed to acute or to chronic hypoxia.Modulation of gene wxpression by nitric oxide.J Clin Invest. 1995Apri95(4): 1798-1807
146. Ziche M, Morbidelli L, Choudhuri R, et al Nitric oxide synthase lies downstream form vascular endothelial growth factor-induced but not basic fibroblast growth factor-indued angiogenesis. J Clin Invest, 1997, Junl;99(11): 2625-2634.
147. Eddahibi S,Humbert M,Sediame S,et al.Imbalance between platelet vascular endothelial growth factor and Platelet-derived growth factor In pulmonary hypertension effect of prostacyclin therapy.Am J ResPir Crit Care Med,2000,162:1493—1499.
148.林勇,陈文彬,程德云.低氧性肺动脉高压大鼠血清IGF-1的变化.江苏医药杂志,2000;26(4):273-275
149. Semenza GL. HIF 1:mediator of physiological and patho-physiologieal responses to hypoxia. JAppl Physiol,2009;88:1474-1480
150. YuAY, Shimoda LA,lyer NV, et al. Impaired physiolofical responses to chronic hypoxia in mice partially deficient for hypoxia.inducibte factorl alpha.J Clin invest, 1999;103:691-696
151. Champion HC, Bivalacqua TJ,Toyoda K,et al.In Vivo Gene transfer of prepro-Calcitonin gene-relat.ed peptide ito the Lung attenuates chronic hypoxia induced pulmonary hypertension in the mouse.Circulation.2000;Fed 29; 101 (8): 923-930
152. Cho A, courtman Dw, Langille BL .Apotosis (programmed Cell death) in arteries of the neonatal lamb. Circ Res, 1995; 76: 168-175
153. Bochaton-Piallat ML,Gabbiani F, Redard M,et al.Apoptosis participates in cellularity regulation during rat aortic intimal thickening .Am J Pathol,1995:May;146(5):1059-1064
154.钟小宁,姚龙.肺血管重建在低氧性肺动脉高压中的作用及其机制.中国呼吸与危重监护杂志,2003;2(4):246-248
155.张秋伟.老年肺心病血液流变学指标分析.中国急救医学杂志,1997;17(5):48
156.何作云,尹翠娥,邓丽萍,等.肺心病患者的表观粘度、氧释放系数与血气的相关性分析.中国病理生理杂志,1993;9(4):468-472
157.高元明,翁心植,陈世伦,等.慢性肺心病患者血小板功能的研究.中华结核和呼吸杂志,1998;21(7):404-406
158.金惠铭.病理生理学(第四版).北京:人民卫生出版社,1995;104-105.
159.王虹,张京岚.慢性肺心病急性期血栓前状态相关指标的临床观测.中国实用内科杂志,1999;19(5):286-288.
160.王洪武,吴省身.慢性肺心病急性发作期t-PA、PAI活性的变化.天津医药,1995;23(9):532-534
161.王辰,杜敏捷,曹大德,等.慢性肺原性心脏病急性发作期肺细小动脉血栓形成的病理观察.中华医学杂志,1997;77(2):123-125
162.廖福龙.临床血液流变学.天津:天津科技出版社.1987.182-183
163. Steiner MC,Singh S,Morgan MD.Stable chronic obstructive pulmonary disease. Incomplete evidence based reviews, may condemn by omission. BMJ,2000,Jan 29;320(7230):312
164. Gorecka D, Gorzelak K,Sliwinski P, et al. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia. Thorax, 1997,52:674-679
165. De Angelis G, Sposato B,Mazzei L,et al. Predictive indexes of nocturnal desaturation in COPD patients not treated with long-term oxygen therapy. Eur Rev Med Pharmacol Sci,2001,5:173-179
166. Zielinski J, Tobias M,Hawrylkiwicz Ⅰ et al. Effects of long term oxygen therapu on pulmonary hemodynamics in COPD patients: a 6 year prospective study.Chest, 1998;113:65-70
167. Baum GL,Wolinsky E. Textbook of pulmonary diseases,5thed. Boston:Little,Brown. 1994(4):90-91
168. McKeon J,Murree-Allen K, Saunders N. Prediction of oxygenation during sleep in patients with Chronic obstructive lung disease.Thorax, 1988, 43: 312-317
169. Chaouat A,Weitzenblum E,Kessler R, et al. Sleep-related 02 desaturation and daytime pulmonary haemodynamics in COPD patients with mild hypoxaemia.Eur Respir J, 1997,10: 1730-1735
170. Fletcher EC, Luckett RA,Goodnight-White S, et al. A double-blind trial of nocturnal supplemental oxygen for sleep desaturation in patients with chronic obstructive pulmonary disease and a daytime PaO_2 above 60 mm Hg. Am Rev Respir Dis,1992,145,1070-1076
171. Eaton TE, Grey C,Garrett JE. An evaluation of short-term oxygen therapy: the prescription of oxygen to patients with chronic lung disease hypoxic at discharge from hospital. Respiratory Medicine, 2001, 95(7): 582-587
172.车东媛.慢性阻塞性肺疾病与肺构形重建.中华结核和呼吸杂志,1999;22(8):472-474
173. Murad F, Leif man DC, Bennett B M,et al. Regulation of guanylate cyclase by atrial natriuretic factor and the role of cyclic GMP in vasodilation. Am J Med Sci,1987,294:139—143.
174.刘乃奎.扩血管药物治疗肺心病肺动脉高压的评价.中国医刊,2000;35(11):8-10
175. Nootens M,Kauffman E,Rich S,et al. Short-term effectiveness of nifedipine in secondary pulmonary hypertension. Am J Cardiol, 1993,71: 1475-1476
176.刘升明,汤泰素,吴义,等.拉西地平防治大鼠慢性常压缺氧性肺动脉高压的实验研究.中国医院药学杂志,1997;17(4):31-35
177. Wanstall JC, Jeffery TK. Recognition and management of pulmonary hypertension. Drugs, 1998, 56: 989
178. Rich S, Brundage BH, Levy PS. The effect of vasodilator therapy on the clinical outcome of patients with primary pulmonary hypertension. Circulation, 1985,71:1191-1196
179.吴为群,容中生,余斌杰,等.硝苯地平与卡托普利单用及联合应用对低氧性肺动脉高压的作用.中国新药与临床杂志,1998;17(1):59-61
180. Hache M,Denault AY, Belisle S,et al. Inhaled prostacyclin (PGI_2) is an effective addition to the treatment of pulmonary hypertension and hypoxia in the operating room and intensive care unit. Can J Anaesth, 2001; 48: 924-929
181. Carlson LA,ORO L. Effect of prostaglandin E_1 on blood Pressure and heart rate in the dog prostaglandin and related factors.Acta Physiol Scand, 1966,67:89-99,
182. Chopra J,Webster RO·PGE_1 inhibits neutrophil adherence and neutrophil-mediated injury to endothelial cells·Am Rev Respir Dis.1988.Oct;138(4):915-920
183.吴宏成,贺广平.前列腺素E_1对肺心病前列环素、血栓素的影响.宁波医学,1997;9(5):205-206
184. Holzan S. Endothelium-induced relaxation by acetylcholine associated with larger rises in cyclic GMP in coronary arterial strips. J cyclic Nucleotide Res,1982;8(6):409-419
185. Frostell C,Fratacci MD,Wain JC,et al. Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation,1991,83(6):2038-2047
186. Pison U, Lopez FA,Heidelmeyer CF, et al. Inhaled nitric oxide reverses hypoxic pulmonary vasoconstriction without impairing gas exchange. J Appl physiol, 1993;74(3): 1287-1292
187. Yoshida M,Taguchi O,Gabazza EC,et al. Combined inhalation of nitric oxide and oxygen in chronic obstructive pulmonary disease. Am J Respir crit Care Med, 1997,155(2):526-529
188. Roberts,JD,Polaner DM,Lang P, et al, Inhaled nitric oxide in persistent pulmonary hypertension of the newborn.Lancet, 1992,340:818-819
189.曹伟标,朱无钰,罗慰慈,等.吸入一氧化氮可降低犬急性缺氧性肺动脉高压.中华内科杂志,1995;34(1):9-12
190. Roze JC,Storme L,Zupan VA, et al.Echocardiographic investigation of inhaled nitric oxide in newborn babies with severe hypoaemia.Lancet,1994,344:303
191. Pepke-Zaba J, Higenbottam TW, Dinh-Xuan AT, et al. Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet, 1991,338:1173-1174
192.何作云.肺心病血液流变学改变及其干预措施.重庆医学.1998;28(4):302-303
193. Bousser MG. Aspirin or heparin immediately after stroke?Lancet. 1997.349:1564
194.张林,郎燕,陈艳玲.小剂量阿司匹林对肺心病血液流变学的影响.现代中西医结合杂志,2001;10(22):2154-2155
195.郭剑超,贾小珍,王珺,等.纤维蛋白原和血液粘滞度的改变与肺心病肺动脉栓塞相关性的探讨.天津医
2.钱桂生.吴国明主编.肺心病的诊断与治疗.北京:人民军医出版设,1999.9
3.蔡如升主编.慢性肺心病20年防治研究.北京:科学技术文献出版社,1994.12
4.程显声.肺心病防治研究进展和策略变化.中华内科杂志,1996;35(11):723-724
5.熊旭东.肺心病肺动脉高压的中西医研究热点.中国中医急症,2000;9(4):174-175
6.崔庆荣,何天有,郭月季,等.中医药治疗肺心病述评.甘肃中医学院学报,2004;21(2):47-50
7.晁恩祥.慢性肺心病急性期286例疗效分析.天津中医,1985;2(1):1-3
8.蔡灿林.洪广祥治疗肺胀的经验.江西中医药,1994;25(2):4-5
9.徐旭东.中西医结合治疗肺心病急性发作64例.四川中医,1996;14(7):22
10.杨林,周若梅.肺胀虚实辨析.陕西中医,1995;16(4):163-164
11.杨明均.慢性肺心病急性发作期81例(85例次)卫气营血辨证分型及防治的探讨.辽宁中医杂志,1982;(1):17-21
12.高洪春.周次清教授诊治慢性肺心病的经验.辽宁中医杂志,1992;19(3):1-3
13.刘振永.中西医结合治疗慢性肺心病急性发作期疗效观察.天津中医,1995;12(3):3-5
14.赵子敏.汪达成治疗肺心病的临床经验.陕西中医学院学报,1994;(4):18-19
15.李若钧.肺胀伏邪的演化规律和特点.山西中医,1994;10(2):3-4
16.刘立东.中医为主治疗肺心病35例疗效观察.湖南中医杂志,1992;8(5):22-23
17.韩树人.肺胀治疗体会.南京中医药大学学报,1995;11(3):19-20
18.黄建庄.肺胀的诊治体会.中原医刊,1995;22(9):22
19.董锡安.中药为主治疗肺心病42例.陕西中医,1992;13(3):101
20.李帮阔.肺胀病辨治点滴.湖北中医杂志,1995;(1):39
21.吴德芸.治疗肺原性心脏病68例临床观察.上海中医药杂志,1994;(7):22-23
22.刘文昭,杨润平.肺心灵治疗慢性肺原性心脏病急性发作期30例临床观察.中医杂志,1992;(10):26-28
23.牛振华,张东有.补阳还五汤治疗肺心病92例.陕西中医,1993;14(11):483
24.吴明华.中西医结合治疗慢性肺源性心脏病急性加重期141例.实用中医药杂志,1996;(2):24-25
25.沈安明.补肺活血汤治疗肺心病46例.安徽中医学院学报,1995;14(1):31
26.王绵丽.润肺化痰法治疗肺心病合并感染50例.陕西中医,1993;14(11):484
27.韩春生.张洪春.活血化瘀治疗肺心病研究近况.黑龙江中医药,1996;(1):54-57
28.陶凯,周晓园,林慧鹃,等.菖蒲雾化剂治疗慢性呼吸衰竭失代偿期临床研究.中医杂志,1996;37(3):161-164
29.宋康.涤痰通腑祛瘀法治疗肺性脑病35例观察.中医杂志,1994;(6):347—348
30.罗本清.吴桂华.肺性脑病的中医辨证治疗探讨.实用中医药杂志,1995;(1):27-29
31.樊亚巍.开闭固脱法在肺性脑病中的应用.实用中医药杂志,1993;(1):11-12
32.单书健,陈小华.古今名医临证金鉴.咳喘肺胀卷(下).北京:中国中医药出版社,1999.8
33.郭振球.肺胀之证治学研究.实用中医药杂志,1994;(6):3-4
34.火树华,赵琨,罗幼琼.慢性肺心病急性发作期中西医结合辨证分型论治的疗效分析.新疆中医药,1986;(2):24-27
35.喻平瀛.慢性肺心病急性发作期按热病论治探讨.南京中医药大学学报,1995;11(4):21-22
36.邓若文,周福生.中西医结合治疗31例肺心病.新中医,1982;(5):20-22
37.段利民.提高中医药治疗肺原性心脏病的疗效管见.河北中医,1994;16(1):3
38.李立.肺心病急性发作期从气论治五法.临床荟萃,1995;10(8):361-362
39.周衡.支饮韧探.河南中医,1982;(2):11-12
40.李若钧.肺胀血瘀证临床论治体会.山西中医.1995;11(6):49-50
41.李文辉.肺胀与血瘀浅探.湖南中医杂志.1994;10(4):27-28
42.周仲瑛.慢性肺源性心脏病的辨治要点.中医杂志,1990;31(1):23-25
43.方邦江,占鸽.宽胸理肺汤治疗慢性肺心病64例.陕西中医.1994;15(4):150
44.张宗铭,陈怀珍,伍丽华.肺心平分型论治肺心病急发期80例.中国中医急症,1996;5(2):56-58
45.王洋.中西医结合治疗肺心病呼吸衰竭21例小结.山西中医,1994;10(2):23-24
46.张素英.中西医结合治疗肺心病急性肺感染疗效观察.天津中医,1995;12(4):5-6
47.付振伟.养阴化痰治疗肺心病.吉林中医药,1995;(5):12
48.李建生,李素云主编.常见老年呼吸系统疾病现代治疗.北京:中国中医药出版社,1996.
49.马全然.清熱祛痰化瘀开窍法治疗肺性脑病的临床观察.天津中医,1996;13(5):18-19
50.高昌杰.中西医结合治疗肺性脑病30例临床分析.实用中医药杂志,1996;(4):23—24
51.曹兴亚.活血化瘀、温阳利水法治疗慢性肺原性心脏病心力衰竭的临床观察.中西医结合杂志,1984;4(10):589
52.刘进才.温阳利水、活血化瘀法治疗肺心病心衰66例.陕西中医.2000,21;(4):147
53.王立军,张雅丽,韩桂芝.消喘散治疗慢性呼吸衰竭临床观察.黑龙江中医药,1996;(2):8-10
54.林群莲,黄发盛.通腑法治疗肺心病急性发作期.实用中西医结合杂志,1996;9(10):621
55.谷元奎,马西文,自拟“通腑泻浊定喘汤”佐治慢性肺心病急性发作31例.临沂医专学报.2000,22;(2):128-129
56.李国贤.通里攻下、活血化瘀法治疗肺心病的疗效观察.江西中医药,1981;(4):12-13
57.魏汉林,杜怀裳.麻杏二三汤治疗肺心病急性发作期250例.中医杂志.1997;38(2):87-88
58.陆德海,段景文,姜光明.加味黛蛤散治疗慢性肺心病急性发作期60例.陕西中医,1995;16(10):435
59.张问渠,张昱主编.老年病中医治疗学.北京:科学技术文献出版社,2000.8
60.洪用森等.水蛭粉用于肺心病.浙江中医杂志,1982;17(3):101
61.袁长瑞,刘秀芬,李成云.中药灌肠治疗肺心病心功能不全的疗效观察.内蒙古中医药,1995;14(3):8-9
62.张水源.参附合川芎嗪注射液治疗肺心病急性发作期的临床观察.中国中西医结合杂志.2002,21;(8):628
63.王学东主编.慢性阻塞性肺疾病中医治疗.南京:江苏科学技术出版社,2002.6.
64.范济平.针刺加穴位贴药治疗慢性支气管炎759例.云南中医杂志,1989;(2):31
65.冯维斌,刘伟胜主编.呼吸科专病.中医临床诊治.北京:人民卫生出版社,2000.9
66.李笑宏,林建海,焦文健.虎杖对缺氧性肺动脉高压动物血流动力学作用的研究.宁夏医学杂志,2001;23(9):515-517
67.刘雪峰,刘青.中医药防治慢性缺氧性肺动脉高压研究进展.中国中医急症,2003;12(5):462-463
68.席思川,阮英卯,张连庄,等.前胡对大鼠缺氧性肺动脉高压逆转效应的实验观察.中国中西医结合杂志,1996;16(4):218-220
69.刘元.辨证治疗肺心病心力衰竭的经验.江西中医药,1994,25(5):23-24
70.段利民.提高中医药治疗肺源性心脏病的疗效管见,河北中医,1994;16(1):3
71.王铁生,段生福,汤秦秦.慢性阻塞性肺病患者的血液流变学改变.中华结核和呼吸杂 志,1989;12(4):228-229
72.陈文彬,颜浩,莫晓能.汉防己甲素对慢性低氧性肺动脉高压大鼠肺内bFGF表达的影响.华西医科大学学报,2001;32(1):12-14
73.康健,于润江,王怀良,等.汉防己甲素降低慢性阻塞性肺疾病肺动脉高压的临床观察.中华结核和呼吸杂志,1993;16(2):93-94
74.岳淼,韩玉永.生水蛭胶囊降低慢性肺源性心脏病血液粘滞度的临床观察.河北中医,1998;20(3):181
75.张守华,赵安芝.中药葛根素对肺心病患者血流动力学的影响,黑龙江中医药,1999;113(3):4-5
76.刘明等主编.呼吸病诊疗全书.北京:中国医药科技出版社,1999,257
77.王学东.慢性阻塞性肺疾病的中医治疗.江苏:江苏科学技术出版社,2002:66-67;92
78.孙琼,张宝陵,孙立勤.黄芪注射液治疗肺心病心衰42例.中国中医急症,1998;7(5):206
79.沈映君.中药药理学.上海:上海科学技术出版社,1997.42-46;68
80.周德奇,王辉.慢性肺心病急性发作期中医药临床治疗研究进展.现代中西医结合杂志,2004;13(13):1804-1807
81.谢灿茂.呼吸系统疾病.北京:科学技术文献出版社,2000.226
82.熊旭东.肺心病肺动脉高压的中西医研究热点.中国中医急症,2000;9(4):174-175
83.蔡柏蔷主编.21世纪医师丛书-呼吸内科分册.北京:中国协和医科大学出版社,2000.477
84. Rihacek I, Soucek M,Toman J. Primary pulmonary hypertension.Vnitr Lek. 1993, Jun;39(6):591-596
85. Incalzi RA,Fuso L,De Rosa M,et al,Electrocardiographic signs of chronic cor pulmonale:A negative Prognostic finding in chronic obstructive Pulmonary disease.Circulation, 1999;Mar 30;99(I 2): 1600-1605
86.尹黎波.继发性肺动脉高压诊断的一些进展.华西医学,1996;11(4):423-426
87,王国干.肺源性心脏病及肺动脉高压的无创性诊断.中国医刊,2000;35(11):5-7
88.邹霞英,辛达临,丁力.慢性阻塞性肺病自然病程与肺动脉压关系.中华结核和呼吸杂志,1988;11(5):271-274
89. The National Emphysema Treatment Trial Research GrouP. Rationale and design or the National Emphysema Treatment Trial: a prospective randomized trial of lung volume reduction surgery. Chest, 1999, 116(6): 1750-1761
90. Oswald-Mammosser M, Weitzenblum E, Quoix E, et al. Prognostic factors in COPD patients receiving long-term oxygen therapy.Importance of pulmonary artery pressure.Chest, 1995,May; 107(5): 1193-1198
91.李海潮.肺源性心脏病的治疗—慢性阻塞性肺病所致肺动脉高压和肺心病的治疗.中国医刊,2000;35(11):10-12
92. Tuder, Rubin M, Voelke NF, et al. Pulmonary hypertension and inflammation. J. Laboratory & Clinical Medicine,1998,Jul 132(1):16-24
93. Voelkel NF, Tuder RM. Cellular and molecular mechanisms in the pathogenesis of severe pulmonary hypertension. Eur Respir J 1995; Dee; 8(12): 2129-2138
94. Arcasoy SM,Christie JD, Ferrari VA,et al.Eehoeardiographie assessment of Pulmonary hypertension in Patients with advanced lung disease.Am J Respir Crit Care Med,2003,Mar,1; 167(5):735—740.
95. Maloney JP. Advances in the treatment of secondary pulmonary hypertension.Curr Opin Pulm Med,2003,Mar; 9(2): 139-143.
96. Sharma S. Treatment of pulmonary arterial hypertension:a step forward. Chest,2003,Jul; 124(1):8-11.
97.王虹,王祥.肺源性肺动脉高压研究进展.江苏医药杂志,2004;30(9)690-692
98.薛全福,谢剑鸣,胡长贵,等.常压缺氧性大鼠肺动脉高压模型的建立.中华结核和呼吸杂志,1989;12(6):350-352
99. Kourembanas S,Moria T, Liu Y, et al. Mechanisms by which oxygen regulates gene expression and cell-cell interaction in the vasculature. Kidney Int, 1997,Feb;51 (2):438-443
100.刘新民,刘秉锟.慢性肺疾病所致肺动脉高压和肺心病发生机制.中国医刊,2000;35(11):4-5
101.李智,王颖,鄂妹玉.肺动脉高压大鼠肺动脉平滑肌细胞1,4,5—三磷酸肌醇受体表达的变化.中国危重病急救医学,2001;13(12):721-723
102. Michelakis ED,Weir EK. The pathobiology of pulmonary hypertension:Smooth muscle cells and ion channels. Ctin Chest Med,2001,Sep;22(3):419-432
103.肖欣荣.陈文彬.钾离子通道活性与缺氧性肺动脉高压.中华内科杂志,1996;35(6):416-418
104. Smimov SV, Robertson TP, Ward JP, et al. Chronic hypoxia is associated with reduced delayed rectifier K~+ current in rat pulmonary artery muscle cells. Am J Physiol,1994, Jan;266(1 Pt 2):H365-370
105.刘琰,徐永健,张珍祥,等.蛋白激酶C激活剂对缺氧性肺动脉高压大鼠离体肺动脉环反应性的影响.中华结核和呼吸杂志,1999;22(2):92-94
106. Xu Y, Stenmark KR, Das M, et al. Pulmonary artery smooth muscle cells from chronically hypoxic neonatal calves retain fetal-like and acquire new growth properties.Am J Physiol ,1997,273(1 Pt 1):L234-245
107. Suzuma K,Takahara N,Suzuma I,et al. Characterization of protein kinase C beta isoform's action on retinoblastoma protein phosphorylation, vascular endothelial growth factor-induced endothelial cell proliferation, and retinal neovascularization. Proc Natl Acad Sci USA, 2002,Jan 22;99(2):721-726
108.冉丕鑫,钟南山.低氧性肺动脉高压发病机理与防治研究现状.现代临床医学生物工程学杂志,1997;3(3):151-154
109. Eddahibi S, Humhert M, Fadal E, et al. Serotonin transporter overexpression is responsible for pulmonary artery smooth muscle hyperptasia In primary pulmonary hypertension. J Clin Invest,2001,Oct; 108(8): 1141-1150.
110.王笑歌,安凤芹,列继华,等.肺心病患者血浆心钠素和肾素-血管紧张素-醛固酮系统的研究.临床内科学,1996,13(4):32-33
111.李恒让.慢性阻塞性肺疾病肺动脉高压的研究现状.临床荟萃,1997;(11):483
112.修相成,李中珂,于普明.肺源性心脏病发病机制及治疗新观念.中国乡村医药,2001;8(5):36-37
113.Hyman Al,Mathe AA,Lippton HL, et al Prostaglandins and the lung.Med Clin North Am,1981 Jul:65(4),789-808
114.宋勇.内皮素、血栓素A_2与肺动脉高压.临床荟萃,1999:14(14):659-661
115.杨和平,吴善,陈云远等.血栓素A2和前列环素与肺心病肺动脉高压关系的探讨.中华内科杂志,1991;30(2):102-103
116.刘芳.COPD并发肺动脉高压的研究进展.国外医学呼吸系统分册,2003;23(4):173-179
117.范蓉,杨万里,漆自立.老年肺心病患者内皮素的检测.中国老年医学杂志,1997;17(6):369-370
118. SuY, Block ER.Role of calpain in hypoxic inhibition of nitric oxide synthase activity in pulmonary endothelial cells.AM J Physiol Lung Cell Mol Physiol,2000;jun;278(6):L1204-1212
119. Giaid A.Nitric oxide and endothelin-1 in pulmonary hypertension. Chest, 1998;Sep;114(3 Suppl):208S-212S
120. Emsley AM,Jeremy JY, Gomes GN, etal.Investigation of the inhibitory effects of homocysteine and copper on nitric oxide-mediated relaxation of rat isolated aorta.Br J Pharmacol, 1999;Feb; 126(4): 1034-1040
121.刘雅.孙培宗,欧阳松云,等.内源性一氧化碳与低氧性肺动脉高压关系的临床研究.中华结核和呼吸杂志,2002;25(9):546-549
122. Wang R,wang Z,Wu L.Carbon monoxide induced vasorelaxation and the underlying mechanisms.Br J Pharmacol,1997,Jul;121(5):927-934
123. Maines MD.The heme oxygenase system: a regulator of second messenger gases.Annu Rev Pharmacol Toxicol, 1997,37:517-554
124. Morita T, Kourembanas S.Endothelial cell expression of vasoconstrictors and growth factors is regulated by smooth muscle cell-derived carbon monoxide.J Clin Invest, 1995,Dec;96(6):2676-2682
125.许军阳,武志杰,潘卫斌.慢性肺心病患者氧自由基和前列腺素代谢的变化.中华内科杂志,1993;10:698
126. Lang RE,Thdken H,Ganten D,et al.Atrial natriuretic factor:a circulating hormone stimulated by volume loading .Nature, 1985,Mar.21-27:314:264-266
127. Comini L,Agnoletti G, Panzali A,et al. Activation of ANP synthesis during congestive heart failure in rats treated with monocrotaline.Am J Physiol,1995,268(1 pt 2):H391-H398
128. Akimoto K, Miyata A, Hayakawa k, et al.Plasma and atrial levels of atrial natriuretic peptide(ANP) in pulmonary hypertensive rats, Life sci, 1988,43 (14): 1125-1132
129.徐金升,丁翠敏,孙志学.内皮素、心钠素与肺心病.国外医学呼吸系统分册.1998;18(2):108-111
130. Pedram A, Razandi M,Levin ER.Natriuretic peptides suppress vascular endothelial cell growth factor signaling to angiogenesis.Endocrinology,2001; 142(4): 1578-1586
131. Martinez A,Miller MJ,Unsworth EJ,et al.Expression of adrenomedullin in normal human lung and in pulmonary tumors Endocrinology, 1995.136(9):4099-4105
132.徐平,戴爱国,周厚德,等.低氧性肺动脉高压大鼠肺内肾上腺髓质素及受体表达研究.中华结核和呼吸杂志,2002;25(8):465-469
133.孙立红,于文成,王兵,等.肾上腺體质素c-型利钠肽神经肽Y与缺氧性肺动脉高压的关系研究,心肺血管病杂志2004;23(4):203-205
134. Saadjian AY, Paganelli F, Ganbert ML,el al Adenosine plasma concentration in pulmonary hypertension.Cardiovasc Res, 1999,43:228-236
135.钟小宁,许辉.低氧性肺动脉高压发病机制及治疗研究进展.医学综述,1998;4(10):541-543
136.叶任高主编.内科学.北京:人民卫生出版社,2001.23
137.卢传义,王迪浔.不同食用油对大鼠肺血管反应性和慢性低氧性肺动脉高压的影响.中国病理生理杂志,1992;8(3):234-237
138. Morganroth ML. Decreased pulmonary vascular responsiveness in rats raised on an essential fatty acid deficient diet. Prostaglandins, 1987,33(2): 181-197
139. Archer SL. Effect of dietary fish oil on lung lipid profile and hypoxic pulmonary hypertension. J Appl Physiol, 1989,66(4): 1662-1673
140.卢传义,王迪浔.饮洒和饮茶对狗低氧性肺血管收缩反应的影响-前列腺素、白三烯的作用.中国病理生理学杂志,1993;9(2):296-298
141. Olschewski H,Rose F, Gruenig E, et al. Cellular pathophysiology and therapy of pulmonary hypertension. J Lab Clin Med,2001,138(6):367-377
142. Adatia I. Recent advances in pulmonary vascular disease. Curt Opin Pediatr,2002,14(3):292-297
143. Andoh Y, Shimura S,Aikawa T, et al. Perivascular fibrosis of muscular pulmonary arteries in chronic obstructive pulmonary disease. Chest, 1992,102:1645-1650
144. Folkman J, Klagsbrun M. Angiogenic factors. Science. 1987, Jan 23;235(4787): 442-447
145. Tuder RM,Flook BE, Voelkel NF Increased gene expression for VEGF and the VEGF receptors KDR/Flk and Flt in lungs exposed to acute or to chronic hypoxia.Modulation of gene wxpression by nitric oxide.J Clin Invest. 1995Apri95(4): 1798-1807
146. Ziche M, Morbidelli L, Choudhuri R, et al Nitric oxide synthase lies downstream form vascular endothelial growth factor-induced but not basic fibroblast growth factor-indued angiogenesis. J Clin Invest, 1997, Junl;99(11): 2625-2634.
147. Eddahibi S,Humbert M,Sediame S,et al.Imbalance between platelet vascular endothelial growth factor and Platelet-derived growth factor In pulmonary hypertension effect of prostacyclin therapy.Am J ResPir Crit Care Med,2000,162:1493—1499.
148.林勇,陈文彬,程德云.低氧性肺动脉高压大鼠血清IGF-1的变化.江苏医药杂志,2000;26(4):273-275
149. Semenza GL. HIF 1:mediator of physiological and patho-physiologieal responses to hypoxia. JAppl Physiol,2009;88:1474-1480
150. YuAY, Shimoda LA,lyer NV, et al. Impaired physiolofical responses to chronic hypoxia in mice partially deficient for hypoxia.inducibte factorl alpha.J Clin invest, 1999;103:691-696
151. Champion HC, Bivalacqua TJ,Toyoda K,et al.In Vivo Gene transfer of prepro-Calcitonin gene-relat.ed peptide ito the Lung attenuates chronic hypoxia induced pulmonary hypertension in the mouse.Circulation.2000;Fed 29; 101 (8): 923-930
152. Cho A, courtman Dw, Langille BL .Apotosis (programmed Cell death) in arteries of the neonatal lamb. Circ Res, 1995; 76: 168-175
153. Bochaton-Piallat ML,Gabbiani F, Redard M,et al.Apoptosis participates in cellularity regulation during rat aortic intimal thickening .Am J Pathol,1995:May;146(5):1059-1064
154.钟小宁,姚龙.肺血管重建在低氧性肺动脉高压中的作用及其机制.中国呼吸与危重监护杂志,2003;2(4):246-248
155.张秋伟.老年肺心病血液流变学指标分析.中国急救医学杂志,1997;17(5):48
156.何作云,尹翠娥,邓丽萍,等.肺心病患者的表观粘度、氧释放系数与血气的相关性分析.中国病理生理杂志,1993;9(4):468-472
157.高元明,翁心植,陈世伦,等.慢性肺心病患者血小板功能的研究.中华结核和呼吸杂志,1998;21(7):404-406
158.金惠铭.病理生理学(第四版).北京:人民卫生出版社,1995;104-105.
159.王虹,张京岚.慢性肺心病急性期血栓前状态相关指标的临床观测.中国实用内科杂志,1999;19(5):286-288.
160.王洪武,吴省身.慢性肺心病急性发作期t-PA、PAI活性的变化.天津医药,1995;23(9):532-534
161.王辰,杜敏捷,曹大德,等.慢性肺原性心脏病急性发作期肺细小动脉血栓形成的病理观察.中华医学杂志,1997;77(2):123-125
162.廖福龙.临床血液流变学.天津:天津科技出版社.1987.182-183
163. Steiner MC,Singh S,Morgan MD.Stable chronic obstructive pulmonary disease. Incomplete evidence based reviews, may condemn by omission. BMJ,2000,Jan 29;320(7230):312
164. Gorecka D, Gorzelak K,Sliwinski P, et al. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia. Thorax, 1997,52:674-679
165. De Angelis G, Sposato B,Mazzei L,et al. Predictive indexes of nocturnal desaturation in COPD patients not treated with long-term oxygen therapy. Eur Rev Med Pharmacol Sci,2001,5:173-179
166. Zielinski J, Tobias M,Hawrylkiwicz Ⅰ et al. Effects of long term oxygen therapu on pulmonary hemodynamics in COPD patients: a 6 year prospective study.Chest, 1998;113:65-70
167. Baum GL,Wolinsky E. Textbook of pulmonary diseases,5thed. Boston:Little,Brown. 1994(4):90-91
168. McKeon J,Murree-Allen K, Saunders N. Prediction of oxygenation during sleep in patients with Chronic obstructive lung disease.Thorax, 1988, 43: 312-317
169. Chaouat A,Weitzenblum E,Kessler R, et al. Sleep-related 02 desaturation and daytime pulmonary haemodynamics in COPD patients with mild hypoxaemia.Eur Respir J, 1997,10: 1730-1735
170. Fletcher EC, Luckett RA,Goodnight-White S, et al. A double-blind trial of nocturnal supplemental oxygen for sleep desaturation in patients with chronic obstructive pulmonary disease and a daytime PaO_2 above 60 mm Hg. Am Rev Respir Dis,1992,145,1070-1076
171. Eaton TE, Grey C,Garrett JE. An evaluation of short-term oxygen therapy: the prescription of oxygen to patients with chronic lung disease hypoxic at discharge from hospital. Respiratory Medicine, 2001, 95(7): 582-587
172.车东媛.慢性阻塞性肺疾病与肺构形重建.中华结核和呼吸杂志,1999;22(8):472-474
173. Murad F, Leif man DC, Bennett B M,et al. Regulation of guanylate cyclase by atrial natriuretic factor and the role of cyclic GMP in vasodilation. Am J Med Sci,1987,294:139—143.
174.刘乃奎.扩血管药物治疗肺心病肺动脉高压的评价.中国医刊,2000;35(11):8-10
175. Nootens M,Kauffman E,Rich S,et al. Short-term effectiveness of nifedipine in secondary pulmonary hypertension. Am J Cardiol, 1993,71: 1475-1476
176.刘升明,汤泰素,吴义,等.拉西地平防治大鼠慢性常压缺氧性肺动脉高压的实验研究.中国医院药学杂志,1997;17(4):31-35
177. Wanstall JC, Jeffery TK. Recognition and management of pulmonary hypertension. Drugs, 1998, 56: 989
178. Rich S, Brundage BH, Levy PS. The effect of vasodilator therapy on the clinical outcome of patients with primary pulmonary hypertension. Circulation, 1985,71:1191-1196
179.吴为群,容中生,余斌杰,等.硝苯地平与卡托普利单用及联合应用对低氧性肺动脉高压的作用.中国新药与临床杂志,1998;17(1):59-61
180. Hache M,Denault AY, Belisle S,et al. Inhaled prostacyclin (PGI_2) is an effective addition to the treatment of pulmonary hypertension and hypoxia in the operating room and intensive care unit. Can J Anaesth, 2001; 48: 924-929
181. Carlson LA,ORO L. Effect of prostaglandin E_1 on blood Pressure and heart rate in the dog prostaglandin and related factors.Acta Physiol Scand, 1966,67:89-99,
182. Chopra J,Webster RO·PGE_1 inhibits neutrophil adherence and neutrophil-mediated injury to endothelial cells·Am Rev Respir Dis.1988.Oct;138(4):915-920
183.吴宏成,贺广平.前列腺素E_1对肺心病前列环素、血栓素的影响.宁波医学,1997;9(5):205-206
184. Holzan S. Endothelium-induced relaxation by acetylcholine associated with larger rises in cyclic GMP in coronary arterial strips. J cyclic Nucleotide Res,1982;8(6):409-419
185. Frostell C,Fratacci MD,Wain JC,et al. Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation,1991,83(6):2038-2047
186. Pison U, Lopez FA,Heidelmeyer CF, et al. Inhaled nitric oxide reverses hypoxic pulmonary vasoconstriction without impairing gas exchange. J Appl physiol, 1993;74(3): 1287-1292
187. Yoshida M,Taguchi O,Gabazza EC,et al. Combined inhalation of nitric oxide and oxygen in chronic obstructive pulmonary disease. Am J Respir crit Care Med, 1997,155(2):526-529
188. Roberts,JD,Polaner DM,Lang P, et al, Inhaled nitric oxide in persistent pulmonary hypertension of the newborn.Lancet, 1992,340:818-819
189.曹伟标,朱无钰,罗慰慈,等.吸入一氧化氮可降低犬急性缺氧性肺动脉高压.中华内科杂志,1995;34(1):9-12
190. Roze JC,Storme L,Zupan VA, et al.Echocardiographic investigation of inhaled nitric oxide in newborn babies with severe hypoaemia.Lancet,1994,344:303
191. Pepke-Zaba J, Higenbottam TW, Dinh-Xuan AT, et al. Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet, 1991,338:1173-1174
192.何作云.肺心病血液流变学改变及其干预措施.重庆医学.1998;28(4):302-303
193. Bousser MG. Aspirin or heparin immediately after stroke?Lancet. 1997.349:1564
194.张林,郎燕,陈艳玲.小剂量阿司匹林对肺心病血液流变学的影响.现代中西医结合杂志,2001;10(22):2154-2155
195.郭剑超,贾小珍,王珺,等.纤维蛋白原和血液粘滞度的改变与肺心病肺动脉栓塞相关性的探讨.天津医