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肺气肿肺心病能否并发

来源:华人健康网 | 发布时间:2010-08-07 09:18:35 | www.chinesejk.com
单纯的支气管哮喘不如慢性支气管炎更易发展成肺气肿和肺心病。但是经常发作,哮喘呈持续状态,尤其是合并慢性支气管炎,出现肺气肿进而发展成肺心病的情况也非罕见。支气管哮喘由于支气管痉挛、粘膜水肿及分泌物增多,使气道受阻,当吸气时,膈肌强烈收缩,肋外肌上提,胸廓扩大,胸腔内负压增大,肺泡扩张,肺脏膨胀,整个胸廓就呈现为肺气肿状态。在哮喘缓解期间,并无肺气肿的临床表现。但如哮喘经常发作,支气管粘膜经常水肿,呼吸道就形成恒久的狭窄。吸气时支气管舒张,气体尚能进入肺泡,呼气时支气管缩小、陷闭,肺内气体不易排出,肺泡内残气量增高,弹性损坏,因此形成阻塞性肺气肿。在慢性阻塞性肺气肿的基础上,随着肺气肿的加重,肺泡内压增高,压迫肺泡壁毛细血管,致使管腔狭窄或闭塞,以至肺泡破裂,肺毛细血管床大为减少,肺循环阻力增大,发生肺动脉高压。继之,慢性阻塞性通气功能障碍及缺氧引起肺细小动脉痉挛,从而加重肺循环阻力和肺动脉高压,造成恶性循环,促使右心室肥厚扩张和右心衰竭。

(编辑:小珊 )

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