摘要
目的：体外循环对肺血管平滑肌细胞有一定的损害作用，本研究旨在观察体外循环对吸入一氧化氮（ＮＯ）气体效应的影响。方法：先天性心脏病合并肺动脉高压患者２８例，体外循环前、后分别吸入９０％Ｏ２和４０ｐｐｍ（１ｐｐｍ＝１０－６）ＮＯ混合气体。结果：体外循环前基础肺血管阻力（ＰＶＲ）３６．４±９．７ｋＰａｓ／Ｌ者６例，吸入ＮＯ后降低了（３５．６±１６．４）％（Ｐ＜０．０５），体外循环后基础ＰＶＲ全部恢复正常（１３．４±９．０ｋＰａｓ／Ｌ）。体外循环前基础ＰＶＲ７４．９±１５．３ｋＰａｓ／Ｌ者１４例，吸入ＮＯ后降低了（２６．５±１２．８）％（Ｐ＜０．０１）；体外循环后基础ＰＶＲ高于正常的患者９例，吸入ＮＯ后降低了（３８．４±２８．７）％（Ｐ＜０．０１），ＰＶＲ降低幅度在体外循环前、后无明显差异（Ｐ＞０．０５）。体外循环前基础ＰＶＲ１５５．６±６４．６ｋＰａｓ／Ｌ者８例，体外循环前、后吸入ＮＯ气体肺动脉压和ＰＶＲ降低均不显著（Ｐ＞０．０５）。结论：先天性心脏病合并肺动脉高压患者，体外循环前、后吸入４０ｐｐｍＮＯ有选择性肺血管松弛作用。
Objective:Cardiopulmonary bypass(CPB)is harmful for pulmonary vascular smooth muscle and endothelial function.We investigated whether the effect of NO is affected by CPB in patients with congenital heart disease. Methods:Twenty eight patients with pulmonary artery hypertension undergoing deformities correction were chosen to inhale 40 ppm NO at FiO 20.90 for 10 min pre and post CPB.We observed the effects of inhalation of NO and compared the effects of inhaled NO pre and post CPB. Results:In 6 patients with baseline pulmonary vascular resistance(PVRb)36 4±9 7 kPa·s/L inhaled NO,pulmonary vascular resistance(PVR)decreased by(35.6±16 4)%( p <0.05)pre CPB;while post CPB baseline pulmonary vascular resistance(PVRa)of these patients were normal(13.4±9.0 kPa·s/L).14 patients with PVRb 74.9±15 3 kPa·s/L ,PVR reduced(26.5±12.8)%( p <0.01)by inhaling NO pre CPB.Post CPB 9 of 14 cases PVRa remained abnormal,PVR by inhaling NO reduced(38.4±28.7)%( p <0.01),but the effects of inhaled NO had no significant difference( p >0 05)pre and post CPB.In 8 patients with PVRb 155.6±64 6 kPa·s/L,PVR of inhaled NO did not significantly reduced pre and post CPB(all p >0.05). Conclusions:Inhaled NO has the effect of selective pulmonary vasodilation pre and post CPB in patients of congenital heart disease complicated with pulmonary artery hypertension,and is not attenuated by CPB.
出处
《中国循环杂志》
CSCD
北大核心
1998年第5期299-301,共3页
Chinese Circulation Journal
关键词
先天性心脏病
肺动脉高压
一氧化氮
体外循环
Congenital heart disease
Pulmonary hypertension
Nitric oxide
Cardiopulmonary bypass
