外源性一氧化氮吸入治疗肺动脉高压的实验研究  

Animal Study of Nitric Oxide Inhalation in Treatment of Pulmonary Hypertension Secondary to Left-to-Right Shunt

作　　者：左顺庆[1] 高尚志[2] 林道明[2] 

机构地区：[1]十堰市太和医院胸心外科,湖北省442000 [2]湖北医科大学附属第一医院

出　　处：《中国循环杂志》2000年第5期306-307,共2页Chinese Circulation Journal

摘　　要：目的 :探讨吸入一氧化氮 (NO)对肺动脉高压动物的肺、体循环压力及肺血管结构重组逆转的影响。　　方法 :实验组 6只 ,对照组 4只。实验组的 6只高动力型肺动脉高压模型犬 ,采用面罩法间断吸入 NO[4 0 ppm(1ppm=1/ 10 6 ) ]1周。观察吸入 NO后肺动脉平均压、体动脉平均压和肺血管阻力及动脉血气变化 ;图像分析法测定肺小血管中膜厚度 ;监测外周血高铁血红蛋白含量。　　结果 :吸入 NO后肺动脉平均压、肺血管阻力明显降低 (P<0 .0 1) ,而体动脉压无变化 ,氧分压升高 ,二氧化碳分压降低。吸入 NO前后肺小血管中膜厚度无明显变化 (P>0 .0 5 )。高铁血红蛋白均低于正常值 15 g/ L。　　结论 :吸入 NO能选择性降低肺动脉压而不影响体动脉压 ,明显改善氧合 ,但对肺血管病理学改变无明显影响 ;吸入NO(40 ppm) 1周未见有明显蓄积毒性作用。Objective:To observe influence of exogenous NO inhalation on pulmonary arterial pressure,systemic arterial pressure and pulmonary vascular remodeling in hyperkinetic pulmonary hypertension (PH). Methods:The model of hyperkinetic PH was built in 6 canines with pulmonary systemic vessel anastomosis.Exogenous nitic oxide (40 ppm) was inhaled via a special mask in an intermittent mode for a week.The following indices were analysesed:①Mean pulmonary arterial pressure (MPAP),mean systemic arterial pressure (MSAP) and pulmonary capillary wedge pressure (PCWP) by Swan Ganz catheter,cardiac output (CO) with thermodilution,pulmonary vascular resistance (PVR) calculated based on them.②Arterial blood gas analysis (systemic).③Methemoglobin (MetHb).④Medial layer thickening (MT) of intra acinar pulmonary artery (IAPA) by IBAS image system. Results:MPAP and PVR elevated obviously in 4 6 months after shunting.After NO giving,MPAP and PVR decreased,oxygenation improved and MSAP were normal,however,MT of IAPA showed no significant change. Conclusion:The selective vasodilation on pulmonary circulation induced by exogenous NO inhalation might decrease MPAP and PVR,improve oxygenation and keep MSAP normal,but have no effect on pathology.There is no significant toxic accumulation effect from NO inhalation at the end of one week.

关 键 词：肺动脉高压 一氧化氮 吸入疗法 治疗 实验研究 

分 类 号：R543.205[医药卫生—心血管疾病]