摘要
目的 评价先天性心脏病合并肺动脉高压患者吸入一氧化氮 (NO)对再灌注肺功能的影响 .方法 先天性心脏病合并中重度肺动脉患者 4 4例 ,分为对照组 (2 2例 )和吸入NO组 (2 2例 ) .吸入 NO组在升主动脉开放即刻连续吸入NO2 0 m L· L- 1 2 4 h,监测和计算平均动脉压 (m Bp)、平均肺动脉压 (m PA)、肺血管阻力 (PVR)、心排出量 (CO) ;氧分压(Po2 )、二氧化碳分压 (Pco2 )、肺泡动脉氧分压差 (A- a Do2 )、肺内动静脉分流 (Qs/ Qt) .结果 吸入 NO组 m PA肺再灌注后3,6 ,12 ,2 4 h分别为 (5 .8± 1.9) ,(5 .6± 1.6 ) ,(5 .1± 1.3)和 (4.4± 1.1) k Pa,对照组为 (7.8± 1.6 ) ,(7.3± 1.7) ,(6 .8± 1.5 )和 (6 .9± 1.5 ) k Pa,吸入 NO组下降显著 (P<0 .0 5 ) ;吸入 NO组 m PVR肺再灌注后 3,6 ,12 ,2 4 h分别为(87± 17) ,(79± 12 ) ,(6 7± 9)和 (6 0± 9) k Pa· s· L- 1 ,对照组为 (14 5± 2 2 ) ,(135± 16 ) ,(130± 14 )和 (114± 11) k Pa· s- 1·L- 1 ,吸入 NO组下降明显 (P<0 .0 5 ) ;吸入 NO组肺再灌注后 6 ,12 ,2 4 h分别为 (4.2± 1.2 ) ,(4.5± 0 .9)和 (4.4± 1.2 )L· min- 1 ,对照组为 (3.3± 0 .8) ,(3.4± 0 .8)和 (3.5± 0 .9)L· min- 1 ,吸入 NO组明显升高 (P<0 .0 5 ) .与对照?
AIM To investigate the effect of inhaled nitric oxide (NO) on the reperfusion lung function of patients with congenital heart diseases and pulmonary hypertension after carddiopulmonary bypass. METHODS 44 patients with congenital heart disease and pulmonary hypertension were divided into the control group ( n =22) and the NO inhaling group ( n =22). The inhaled NO group patients inhaled NO (20 ppm) for 24 h as soon as lung reperfusion started. Patients'hemodynamics and lung function were monitored and white blood cell count was measured. RESULTS The mean Pulmonary arterial pressures decreased significantly in the NO inhaling gruop than in the control group at 3, 6, 12, 24 h after the lung reperfusion (5.8±1.9), (5.6±1.6), (5.1±1.3) and (4.4±1.1) kPa vs (7.8±1.6), (7.3±1.7), (6.8± 1.5) and (6.9±1.5) kPa respectivelly ( P <0.05). Pulmonary vascular resistance decreased significantly in the NO inhaling gruop than in the control group at 3, 6, 12, 24 h after lung reperfusion (87±17), (79±12), (67±9) and (60±9) kPa·s -1 ·L -1 vs (145±22), (135±16), (130±14) and (114±11) kPa·s·L -1 respectively ( P <0.05); Cardiac output of the control group lowered compared that of the NO inhaling gruop in at 6, 12, 24 h (3.3±0.8), (3.4±0.8) and (3.5±0.9) L·min -1 vs (4.2±1.2), (4.5±0.9) and (4.4±1.2) L·min -1 . respectively ( P <0.05). Compared with the control group at 12, 24 h, Arterial oxygen pressure was markedly improved (15.4±2.2) and (16.2± 1.9) kPa, the ratio of arterial to alveolar (2.6±0.8 and 2.2± 0.7)kPa intrapulmoary shuntand (24.6±2.3) and (21.3± 2.5)decreased respectively ( P <0.05) in the NO inhaling group. CONCLUSION Inhaling NO could ameliorate the hemodynamics and lung function of the patients with congenital heart diseases and pulmonary hypertension after cardiopulmonary bypass.
出处
《第四军医大学学报》
CAS
北大核心
2002年第20期1912-1915,共4页
Journal of the Fourth Military Medical University
基金
福建省科委基金资助项目 (2 0 0 1Z0 3 1)
福建省教育厅基金资助项目 (K2 0 0 10 70 )
关键词
先天性心脏病
肺动脉高压
心内直视手术
肺功能
一氧化氮
心肌再灌注
hypertension, pulmonary
nitric oxide
myocardial Reperfusion
lung/physiopathology
respiratory function tests
