中文摘要：

目的 分析慢性阻塞性肺病（COPD）相关肺动脉高压（PH）的临床特征及肺动脉压力相关因素。方法 回顾性分析慢性阻塞性肺病急性加重期（AECOPD）患者353例，用心脏彩色多普勒超声测量肺动脉收缩压（PASP），根据PASP结果分为对照组〈40mmHg，轻度PH组40～50 mmHg，中重度PH组≥51 mmHg，比较三组患者体重指数、血浆D-Ⅱ聚体、肺功能、肺CT图像上的主肺动脉直径与升主动脉直径、降主动脉直径等指标。结果 353例AECOPD患者中，合并PH患者101例，占总数28.61%。轻度PH患者74例；中重度PH患者27例，其中“不成比例”的PH患者3例。轻度PH组血浆D-Ⅱ聚体及中重度PH组均明显高于对照组，有统计学意义（p均〈0.05）。轻度PH组PaCO2及中重度PH组均高于对照组,无统计学意义（p均〉O.05）。相比对照组，轻度PH组及中重度PH组在用力肺活量（FVC）、一秒用力呼气容积（FEVl）、FEVl／FVC、每分钟最大通气量（MVV）差异均无统计学意义（均P〉0.05）。肺CT中中重度PH组及轻度PH组主肺动脉直径均明显大于对照组，有差异有统计学意义（P〈0.05）；中重度PH组降主动脉直径明显高于对照组，差异有统计学意义（P〈0.05）；B、中重度PH组的主肺动脉直径与降主动脉直径比值均大于对照组，有统计学意义（P均〈0.05）。结论 COPD相关的PH多为轻度至中度，有少数“不成比例”的PH；肺功能与肺动脉压力无明显相关性；血浆D-Ⅱ聚体在评估PH严重程度方面有一定的价值；胸部CT主肺动脉直径及主肺动脉直径与降主动脉直径比可作为评估PH的指标。

英文摘要：

Objective To investigate the clinical characteristics and stress related factors of patients with chronic obstructive pulmonary diseases （COPD） associated with pulmonary hypertension （PH）. Methods Retrospective study of 353 patients with COPD were divided into three groups according to pulmonary artery systolic pressure （PASP）measured by echocardiography： group A （control group） 〈 40 mmHg, group B （mild PH group） 40 - 50 mmHg, group C （moderate -severe PH group）≥51 mmHg. Body Weight index, D - Ⅱ polymer, blood - gas analysis, pulmonary function test, diameters of main pulmonary artery （MPA） and aorta were compared a- mong the groups. Results Of all 353 patients with COPD,there were 101 （28.61%） patients associated with PH. According to PASP measured by echocardiography,there were 74 patients in group B and 27 patients in group C. The D - Ⅱ polymer of patients in group B and group C were significantly higher than that of patients in group A （P 〈 0. 05 ）. The PaCO2 of patients in group B and group C were higher than were in control group,but it did not have statistics significance （P 〉 0. 05）. Compared with A group, FEVI.o, FVC, FEV1/ FVC, MVV of all patients were similar in group B and group C. The MPAD of patients in group B and group C were significantly higher than were in group A （ P 〈 0. 05 ）. The DA of patients in group C was significantly higher than was in A group （ P 〈 0.05 ）. MPAD/DA in group B and group C were all higer than the control group （P 〈 0.05）. Conclusion The majority of PH in COPD is mild to moderateand only few patients belonged to ＂out of proportion＂ PH. There is no direct relationship between changes in pulmonary function and severi- ty of PH in COPD patients. D - Ⅱ polymer has some value to evaluate and appraise the level of PH. And the diameter ratio of main pulmona- ry artery to descending aorta on CT scan show excellent diagnostic value,which can be used to screen for COPD associated with PH.