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Background: Cor pulmonale is a synonym for pulmonary heart disease. The term 揷or pulmonale� if broken into its constituents 揷or� (heart) and 損ulmo� (lungs), means cardiac involvement due to pulmonary diseases. Chronic cor pulmonale is not a single disease entity but resulting secondary to many bronchopulmonary vascular diseases and also from thoracic cage abnormalities. Cor pulmonale accounts for 5-10% of all heart diseases, 20-30% of all admissions for heart failure and 9.2% in the cardiac autopsies.Methods: This was a hospital-based study carried among patients diagnosed with chronic cor pulmonale admitted to the medical wards of Karnataka institute of medical sciences, Hubli. during December 2011- November 2012 using simple random sampling method.Results: The following observations were made in 50 representative cases the age group of patients was between 24 to 85 years. Chronic cor pulmonale was commonly seen in middle and elderly age groups. Incidence below 35 years is very less. Almost every patient of chronic cor pulmonale presented with breathlessness and cough. All patients in the study had Tachypnoea, Diminished chest movements, Prominent use of accessory muscles of respiration, Cyanosis, Clubbing (in some patients), Crepitations and rhonchi on chest auscultation, Loud P2 and pansystolic murmur in Tricuspid area on cardiac auscultation.Conclusions: The peak incidence of chronic cor pulmonale was found to be in the middle and older age groups with high incidence during winter season. Smoking and dusty environment at the site of occupation were aggravating the primary lung disease. Breathlessness, cough and edema of the feet were the most common symptoms.
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Objective To observe the influence of phentolamine on N terminal B-type natriuretic peptide precursor(NT-proBNP),blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale Methods One hundred and one cases patients with chronic cor pulmonale were randomly divided into two groups,51 patients in the treatment group,50 patients in the control group.All patients were treated with normal anti-infection,eliminating phlegm to smooth wheezing antithrombotic for one week,as the same time patients in the treatment group were treated with phentolamine for one week.Through observed the treatment effect of phentolamine to chronic cor pulmonale,the level of NT-proBNP,blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale before and after the treatment were analyzed.Results Compared with before treatment,the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein,plasma D dimer were lower than after one week in two groups,while the level of PO2 was higher.Treatment group:NT-proBNP (1 712.76±572.32) ng/L vs.(271.59±163.05) ng/L,t=20.42,P<0.05,PCO2 (66.34±5.81) mmHg vs.(52.58±5.82) mmHg,t=16.46,P<0.05,PO2 (59.28±6.13) mmHg vs.(73.64±6.10) mmHg,t=23.02,P<0.05,hypersensitive c-reactive protein 86.0(28.0) mg/L vs.23.0(12.0) mg/L,Z=-6.22,P<0.05 mg/L,plasma D-dimer (4 953.37±1 654.09) μg/L vs.(1 847.90±838.66) μg/L,t=17.11,P<0.05.Control group:NT-proBNP (1 527.24±658.70) ng/L vs.(612.58±357.59) ng/L,t=14.52,P<0.05,PCO2 (65.41±5.23) mmHg vs.(56.46±5.65) mmHg,t=13.04,P<0.05,PO2(60.57±5.84) mmHg vs.(67.21±5.19) mmHg,t=-10.06,P<0.05,hypersensitive c-reactive protein 79.0(29.0) mg/L vs.43.0(20.0) mg/L,Z=-6.16,,P<0.05,plasma D-dimer (4 408.02±1 682.83) μg/L vs.(2 598.28±1 242.73) μg/L,t=12.15,P<0.05.But the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer reduced significantly,the level of PO2 increased more significantly in treatment group(t(z)=-6.19,-3.39,-7.16,-3.56,5.70,all P<0.05).Conclusion Phentolamine can reduce the level of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer and increased the level of PO2 in patients with chronic cor pulmonale.Phentolamine combined with routine treatment can improve the clinical efficacy of patients with chronic cor pulmonale.
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Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.
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[Objective]It is to observe the clinical effect of bleeding in Zhongfu on pulmonary arterial hypertension induced by chronic cor pulmonale. [Methods]60 cases of patients with chronic cor pulmonale were randomly divided into two groups. Control group was given standardizing normal drugs , and the treatment group was added with bleeding in Zhongfu on the basis treatment above. Pulmonary artery pressure and index of blood rheology were compared between the two groups after 14 days. [Results]Compared with each other,the difference was significant( P<0.05). Indexes of pulmonary artery and blood rheology were al improved obviously after treatment in both groups, especial y in treatment group( P<0.05). [Conclusion]Combination with bleeding in Zhongfu can more effectively increase the clinical effect, low down pulmonary artery pressure and improve blood viscosity.
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Objective To study the evaluation function of Tei index for right heart function of elderly patients with chronic cor pulmonale .Methods Choosed 98 cases of elderly patients suspected chronic cor pulmonale and 68 cases of the medical health elder-ly population from March 2009 to March 2012 in our hospital as group A and B ,ultrasonic inspection and Tei index were measured , ultrasonic inspection indicators contains ,right room transverse diameter ,the main pulmonary artery diameter ,wall thickness and be-fore in pulmonary artery systolic pressure .Results A group of 31 patients(31 .6% ) with a clear cor pulmonale ultrasonic signs ,42 patients(42 .9% ) did not see clearly cor pulmonale ultrasonic signs ,but there was three tricuspid valve and (or) pulmonary valve re-gurgitation ,27 cases(25 .5% ) patients were not seen clear cor pulmonale ultrasonic signs ,and did not see the tricuspid valve and pulmonary valve regurgitation ,three types of Tei index patients were significantly higher than the group B (P<0 .05) .Conclusion Tei index can reflect patients right heart function and can be used as a sensitive index evaluation .
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Objective:To investigate the relation among platelet activation marker(GPⅡb/Ⅲa,CD62p) and amounts of fibrinogen (FG) and of D-dimer (DD) in elderly patients with chronic cor pulmonale exacerbation.Methods:Subjects were divided into four groups (42 elderly patients with chronic cor pulmonale exacerbation,42 elderly patients with chronic cor pulmonale remission stage,30cases of healthy elderly controls and 30 cases of healthy non-elderly controls).Positive rates of GPⅡb/Ⅲa and CD62p were measured with tricolor flow cytometry.We also determined FG and DD in patients with chronic cor pulmonale and in normal controls.Results:Compared with those of chronic cor pulmonale remission stage group,healthy elderly group and healthy non-elderly group,the levels of GPⅡb/Ⅲa,CD62p,FG and DD increased significantly in elderly patients with chronic cor pulmonale exacerbation (all P<0.001).There was a positive correlation between the amount of GPⅡb/Ⅲa or CD62p and the amount of FG and DD in elderly patients with chronic cor pulmonale exacerbation.Conclusion:There is increased coagulation and platelet activity in elderly patients with chronic cor pulmonale exacerbation,and there is a significant correlation between platelet activity and hypercoagulability.
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Objective To investigate the effect of ultrashortwave diathermy on pulmonary hypertension in patients with chronic cor pulmonale(CCP), and its mechanism. Methods Eighty-seven cases of acute phase CCP were divided into 2 groups: an ultrashortwave treatment group, in which 45 patients were treated with both ultrashortwave diathermy and conventional treatment; and a control group, in which 42 patients received regular treatment. The plasma levels of VEGF, ET-1 and the PaO_2, mPAP and FEV1.0 in the two groups were measured before and after treatment. Results In contrast to the control group, the FEV1.0 and PaO_2 of the experimental group were remar-kably increased, while their VEGF, ET-1 and mPAP were significantly decreased after treatment. VEGF and ET-1 were negatively related to PaO_2, and positively related to mPAP. Conclusions Ultrashortwave therapy is effective in treating pulmonary hypertension in patients with CCP. The mechanism for this may involve the synthesis and release of VEGF and ET-1.
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Objective To evaluate the significance of sIL 2R and TNF ? in chronic cor pulmonale.Methods The sIL 2R and TNF ? were detected by means of ELISA.The correlation with PaO 2 and PaCO 2 was analyzed using linear correlation.Results The levels of sIL 2R and TNF ? in patients at exacerbation stage were higher than that of remission stage and normal controls (P
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A synchronous observation of pH, PaO_2 and PaCO_2in contrast to their corresponding Hb, HCT and Vb was made in 89 cases of chronic cor pulmonale with respiratory failure.The results showed that the Hb, HCT and Vb of the patients were apparently higher than the normal (P
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To investigate the relationship between plasma levels of TXB2, 6-KPGF1?, cAMP and cGMP and the hemodynamics of hypoxemia, 30 patients with chronic cor pulmonale (CCP) were studied. The influence of hypoxemia and isosorbide dinitrate therapy was also observed. The results showed: 1) Plasma TXB2 level was significantly higher and plasma 6- KPGF1? level was significantly lower in CCP patients than in healthy controls. There was a negative correlation between 6 KPGFl? and-Ppa levels and a positive correlation between TXB2, TXB2/ 6 KPGF1? ratio and Ppa levels. 2) High levels of plasma TXB2 and TXB2 / 6-KPGF1? were found in hypoxemia cases when the PaO2 level was less than 6.67 kPa (50 mmHg). 3) Reduced Ppa after isosorbide dinitrate infusion elevated the plasma levels of 6-KPGF1?, cAMP, and the cAMP/cGMP ratio, and reduced those of TXB2 and the TXB2/6-K.PGF1? ratio.