雾化吸入一氧化氮供体治疗新生猪急性低氧性肺动脉高压  

Effects of nebulized nitric oxide donors on acute hypoxic pulmonary hypertension in newborn piglets

作　　者：夏红萍[1] 黄国英[1] 孙波[2] 陈超作 

机构地区：[1]复旦大学附属儿科医院心血管中心,上海200032 [2]复旦大学附属儿科医院呼吸急救实验室,上海200032 [3]复旦大学附属儿科医院新生儿科,上海200032

出　　处：《中华急诊医学杂志》2006年第2期117-120,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金资助项目(30170989);教育部高等学校骨干教师资助项目(200066)

摘　　要：目的探讨雾化吸入一氧化氮供体对新生猪急性低氧性肺动脉高压的作用和安全性。方法持续低氧(FiO2=0.1)1h建立急性低氧性肺动脉高压模型。18头新生猪造模后随机分成3组(每组6只):C组(生理盐水组)、NTG组(硝酸甘油组)和SNP组(硝普钠组),另6头新生猪设为S组(假手术组),作为对照。实验过程中连续监测平均股动脉压(MAP)和平均肺动脉压(MPAP),基础状态、缺氧1h、雾化结束时和雾化后0.5h测定动脉血气分析,雾化结束时测定全血高铁血红蛋白(MetHb)水平和血浆NO代谢产物(NO-2NO-3)的含量。结果缺氧1h后,C组、NTG组和SNP组的MPAP均较S组显著升高(P<0.01);雾化结束时,NTG组和SNP组的MPAP较C组显著下降(P<0.05)。在相同时点,4组新生猪的MAP差异无显著性(P>0.05)。雾化吸入结束时,4组新生猪的全血MetHb和血浆NO浓度差异无显著性(P>0.05)。雾化结束后,未发现有反跳性肺动脉高压。结论雾化吸入NTG或SNP能选择性地降低急性低氧引起的肺动脉高压。Objective To observe the effects of nebulized nitric oxide donors on pulmonary and systemic hemodynamics during pulmonary hypertension induced by hypoxia （FiO2 -0.1, for 1 hour） in newborn piglets. Methods Twenty-four anesthetized and mechanically ventilated piglets were randomly divided into four groups： （1） group S （n = 6）, control group; （2） group C （n = 6）, receiving saline after hypoxia; （3） group NTG, receiving nebulized nitroglycerin after hypoxia; （4） group SNP, receiving nebulized sodium nitroprusside after hypoxia, Mean arterial pressure （MAP） and mean pulmonary arterial pressure （MPAP） were monitored continuously. Arterial blood gas analysis was determined at baseline, 1 hour after hypoxia, termination of nebulization and 0.5 h after nebulization, After nebulization, blood methcmoglobin （MetHb） and plasma NO level were measured.Results Acute hypoxia resulted in a significant increase in MPAP. At 1 hour after hypoxia, MPAP in group C, group NTG and group SNP were significantly higher than that in group S （ P 〈 0.01 ）. After nebulization, MPAP in group NTG and group SNP were significantly lower than that in group C （P 〈0.05）. There was no significant difference in MAP between groups at the same time points （P 〉 0.05）. After nebulization, there were no significant differences in plasma NO level and blood MetHb level between groups. No rebound pulmonary hypertension was observed after withdrawal of nebulization. Conclusion Both NTG and SNP nebulization could be used as selective pulmonary vasodilators for acute hypoxic pulmonary hypertension.

关 键 词：缺氧 肺动脉高压 一氧化氮供体 雾化吸入 

分 类 号：R722.1[医药卫生—儿科]