吸入NO治疗急性缺氧性肺动脉高压的实验研究  

EXPERIMENTAL STUDIES OF NO INHALATION ON ACUTE ANOXIC PULMONARY HYPERTENSION

作　　者：宋元林[1] 白春学[1] 洪群英[1] 方智野[1] 任自力[1] 钮善福[1] 

机构地区：[1]上海医科大学中山医院肺科,200032

出　　处：《上海医科大学学报》1997年第4期254-258,共5页Journal of Fudan University(Medical Science)

摘　　要：了解NO吸入治疗急性缺氧性肺动脉高压的效果以及不同模式吸入NO对血流动力学的影响。给10条杂种犬吸入12％氧和88％氮混合气建立缺氧性肺动脉高压的动物模型，采用自身对照法，观察吸入（25—30）×10－6NO前后血流动力学的变化以及换用不同通气模式对以上各指标的影响。吸入12％氧和88％氮混合气30min后平均肺动脉压上升至基础值的206.13％，吸入NO1～2min内平均肺动脉压开始下降，5min后处于稳定状态，从（2.02±0.99）kPa降至（1．23±0．35）kPa（P＜0．02），基本恢复至缺氧前的基础值。在此过程中心输出量从（1．35±0．62）L／min至（1．34±0．62）L／min（P＞0.05）、体循环阻力从（1075.02±565．08）（kPa·S）/L至（1072.85±525．30）（kPa·s）／L（P＞005）均无明显改变。此外，在不同通气模式中（间歇正压通气-IPPV、双水平气道正压通气-BiPAP、压力释放通气-APRV、反比通气-IRV）配合吸入NO均可观察到以上现象，各模式之间相互比较对血流动力学的影响基本无差别。吸入NO可以选择性降低急性缺氧性肺动脉高压而不影响心输出量、系统循环阻力，不同通气模式并不影响NO的上述作用。PURPOSE The aim of this study was to test the effect of inhalation of NO on acute anoxic pulmonary hy－pertension，as well as the role of different ventilatory modes companying with NO inhalation． METHODS Anoxic pulmonary hypertension mode was induced by following a gas mixture of O2（12%）and N2(88%( in ten dogs． Inhalation of NO given by different ventilatory mode，hemodynamics were measured before and after the inhalation of NO． RESULTS Pulmonary artery pressure of dogs increased above baseline after inhalation of gas mixture d O2(12%)and N2(88%)．Meanpulmonaryarterialpressurefrom(2．02±0．99)kPato(1．23±0．35)Kpa(P<0．02)and pullnonary vascular resistance(PVR)from(96．01±62．17)(kPa·s)/L to (5 .83±41．56)(kPa·s)/L)P<0． 02) decreased after inhalation of NO．Cardiac output(CO)，systemic vascular resistance(SVR)were not significantly affected.No difference was observed among ventilatory modes． CONCLUSIONS Inhalation of NO can reverse the pulmonary vasoconsrtiction selectively， and its effect isnot significantly affected by ventilatory mode．

关 键 词：缺氧 肺动脉高压 一氧化氮 吸入 

分 类 号：R543.205[医药卫生—心血管疾病]