酚妥拉明和一氧化氮对未成年家犬肺损伤肺部气体交换影响的比较  

Comparison of the Effects of Inhaled Nitric Oxide and Intravasculare Regitine on Pulmonary Gas Exchange in Young Dogs with Oleicacid Acute Lung Injury

作　　者：许玉霞[1] 周同甫 华益民 王泽蓉 金仲和 

机构地区：[1]川北医学院儿科

出　　处：《华西医科大学学报》1998年第1期85-88,共4页Journal of West China University of Medical Sciences

摘　　要：为了更好地治疗小儿肺部疾病引起的低氧血症，采用急性肺损伤（ＡＬＩ）家犬模型，观察静脉注射酚妥拉明（１０μｇ／ｋｇ．ｍｉｎ）和吸入ＮＯ（４０ｐｐｍ）对血气、肺内分流及血流动力学指标的影响。结果显示：吸入一氧化氮后，肺动脉压（ＰＡＰ）下降（Ｐ＜０．０５），体循环血压（ＳＡＰ）无改变，血氧分压（ＰａＯ２）和血氧饱和度（ＳａＯ２）增加，但差异无显著性（Ｐ＞０．０５），肺内分流（Ｑｓ／Ｑｔ）降低（Ｐ＜０．０５）；静脉注射酚妥拉明后，ＰＡＰ和ＳＡＰ下降（Ｐ＜０．０１），Ｑｓ／Ｑｔ增加（Ｐ＜０．０１）。上述结果表明，酚妥拉明的扩血管效应无选择性，在降低肺动脉压的同时使血气指标恶化，提示对该药在小儿肺部疾病的常规应用中宜持慎重态度。而吸入ＮＯ可以选择性地扩张通气良好区域的肺血管，是一种有希望的辅助疗法。In order to find an agent which truly improves hypoxemia of some serious pediatric lung diseases,the authors examined the independent effects of nitric oxide inhalation and regitine infusion on blood gases,intrapulmonary shunt and hemodynamics in young dogs with oleicacid acute lung injury.After nitric oxide inhalation,the results showed moderate increases in PaO2 and SaO2 (P>005) and a significant decrease in Qs/QT ratio(P<001).There was a significant decrease of PAP(P<005),while SAP remained unchanged.After regitine infusion,however,there were marked decreases in PaO2 and SaO2 (P<001);meanwhile,Qs/Qt rose (P<005).These suggest that with the presence of pulmonary pathology nitric oxide inhalation may alleviate the elevated pulmonary pressure without alteration in systemic artery pressure;so it can improve pulmonary ventilationperfusion distribution and cause favorable changes in blood gases.On the other hand,regitine,as a nonselective vasodilator,reduces pulmonary artery pressure at the cost of significant worsening of blood oxygenation and systemic hypotension;so its routine use in childhood pulmonary diseases should be cautiously considered.

关 键 词：肺气体交换 一氧化氮 酚妥拉明 肺损伤 治疗 

分 类 号：R563.05[医药卫生—呼吸系统]