| 摘要: |
| 目的：探讨吸入一氧化氮(NO)和静滴前列腺素E1(PGE1)对急性肺动脉高压的治疗作用。方法：通过静脉持续滴注血栓素类似物U46619复制犬急性肺动脉高压实验模型，观察静滴小剂量PGE1 10ng/（min.kg），大剂量PGE1 50ng/（min.kg）和吸入体积分数为4.0×10-5 NO及合并PGE1 10ng/（min.kg）对急性肺动脉高压的血流动力学影响。结果：小剂量PGE1使肺动脉平均压（MPAP）下降(17±8)％，体动脉平均压（MSAP）下降(19±10)％，心排量（CO）明显改善［(1.21±0.25)L/min vs （1.83±0.27）L/min， P<0.01］；大剂量PGE1使MPAP下降(29±7)％，MSAP下降(41±11)％，CO呈明显下降趋势［(1.21±0.25) L/min vs（1.04±0.38）L/min，P<0.05］；吸入NO 4.0×10-5以后，MPAP下降(23±6)％，而 MSAP无明显变化，CO上升不明显［(1.34±0.17)L/min vs （1.43±0.24）L/min，P<0.05］；吸入NO 4.0×10-5合并小剂量PGE1后，MPAP下降(31±7)％，MSAP下降(14±9)％，CO明显改善［(1.34±0.17)L/min vs（2.01±0.34）L/min，P<0.01］。结论：吸入NO合并小剂量的PGE1不仅能明显降低肺动脉压，而且可适当扩张体循环血管，改善心功能，有利于各组织的血液灌注，是一种较为理想的治疗方案。 |
| 关键词: 高血压，肺性 前列腺素E类 一氧化氮 |
| DOI： |
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| 基金项目: |
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| Treatment of acute pulmonary hypertension with intravenous PGE1 and inhaled nitric oxide |
| 徐志云,郝家骅,朱家麟,张宝仁,韩林 |
| () |
| Abstract: |
| Objective: To compare the therapeutic efficacy between intravenous PGE1 and inhaled NO in the treatment of acute pulmonary hypertension. Methods: In 7 dogs, pulmonary hypertension was induced by infusion of the thromboxane analogue U46619 to observe the effect of intravenous administration of small dose PGE1 10 ng/(min*kg), large dose PGE1 50 ng/(min*kg),inhaled NO 4.0×10-5and inhaled NO plus small dose PGE1 on the hemodynamics of acute pulmonary hypertension. We measured the changes of hemodynamic variables after each drug given. Results: Intravenous administration of small dose PGE1 resulted in a decrease in MPAP by (17±8)%, MSAP by (19±10)%, and an increase of CO from (1.21±0.25) L/min to (1.83±0.27) L/min(P＜0.01). Intravenous administration of large dose PGE1 resulted in a decrease in MPAP by (29±7)%, MSAP by (41±11)%, and CO from (1.21±0.25) L/min to (1.04±0.38) L/min (P<0.05). Inhaled NO resulted in a decrease in MPAP by (23±6)%, but no significant changes of MSAP and CO were observed. Inhaled NO plus small dose PGE1 resulted in a decrease in PAPm by (31±7)%, SAPm by (14±9)%, and an increase of CO from (1.34±0.17) L/min to (2.01±0.34) L/min (P<0.01). Conclusion: Inhaled NO plus small dose PGE1 can not only decrease pulmonary artery pressure significantly, but also dilate the system artery and improve cardiac function, which will be useful to blood infusion of other tissues. |
| Key words: hypertension, pulmonary prostaglandins E nitric oxide |
