外源性一氧化氮及氦-氧混合气对支气管哮喘患者通气功能的影响  

The effect of inhaled nitric oxide and helium oxygen mixture on the pulmonary function of asthmatics

作　　者：马迎民[1] 刘又宁[1] 朴哲龙[1] 郝凤英[1] 

机构地区：[1]解放军总医院呼吸科

出　　处：《中华内科杂志》1999年第4期224-227,共4页Chinese Journal of Internal Medicine

摘　　要：目的探讨同时吸入氦氧混合气和不同浓度的一氧化氮（ＮＯ）对支气管哮喘患者通气功能的影响。方法选取１８例哮喘患者随机分为两组，一组吸入氦氧混合气的同时加入１００ｐｐｍ的ＮＯ，另一组则加入４０ｐｐｍ的ＮＯ。在不同时间检测患者的通气功能，并与吸入β２受体激动剂进行比较。结果哮喘患者吸入氦氧混合气后与呼吸空气比较其用力肺活量（ＦＶＣ）、１秒钟用力呼气容积（ＦＥＶ１）、呼气流速峰值（ＰＥＦＲ）和最大呼气中段流量（ＭＭＥＦ）均显著上升，而且ＦＥＶ１和ＭＭＥＦ显著高于单独吸入沙丁胺醇，停止吸入后１分钟上述指标即迅速回落。吸入氦氧混合气的同时加入１００ｐｐｍ的ＮＯ可使哮喘患者ＦＥＶ１和ＰＥＦＲ进一步上升，但ＦＶＣ和ＭＭＥＦ未发生变化。加入４０ｐｐｍ的ＮＯ不引起上述通气指标的变化。结论氦氧混合气能显著提高哮喘患者的通气功能，而ＮＯ的支气管扩张作用相对较弱。Objective To investigate the effect of inhaled nitric oxide (NO) combined with helium oxygen mixture on the pulmonary function of asthmatics. Methods 18 asthmatic patients were included in this study. The patients were divided into two groups randomly. One group of patients inhaled 100 ppm NO combined with helium oxygen mixture , the other group inhaled 40 ppm NO containing helium oxygen mixture . Pulmonary function was examined intermittently during the study process and compared with that of the patients treated with salbutamol. Results It is shown that inhalation of helium oxygen mixture improved the forced vital capacity, forced expiratory volume during the first 1.0 second (FEV 1), peak expiratory flow rate (PEFR) and maximal midexpiratory flow rate (MMEF) significantly as compared with in halation of air . Although salbutamol inhalation improved FEV 1 and MMEF, the effect was weaker than helium oxygen mixture inhalation. However the effect of helium oxygen mixture lasted only one minute. Inhalation of 100 ppm NO with helium oxygen mixture only slightly improved FEV 1 and PEFR as compared with inhalation of helium oxygen mixture . 40 ppm NO with helium oxygen mixture did not influence the pulmonary function in the asthmatic patient as compared with helium oxygen mixture alone. Conclusion It is suggested that inhalation of helium oxygen mixture can improve the pulmonary function of asthmatic patients significantly. However, inhalation of NO exerts a weak bronchodilatory effect.

关 键 词：哮喘 一氧化氮 氦-氧混合气 治疗 

分 类 号：R562.250.5[医药卫生—呼吸系统] R974.3[医药卫生—内科学]