速尿卡托普利治疗高原肺水肿患者的临床研究

Clinical effects of furosemide and captopril on patients with high altitude pulmonary edema

目的:评价速尿、卡托普利对高原肺水肿(HAPE)的临床疗效。方法:采用右心漂浮导管的研究方法,观察了应用速尿、卡托普利对患者血流动力学的影响,同时采用Lakelouise评分法对患者的病情进行定量评估。结果:速尿能明显降低HAPE患者的肺动脉压,而体动脉血压、心输出量、心率等血流动力学指标用药前后相比无明显变化。应用速尿后,HAPE患者的病情定量分数亦明显低于用药前;卡托普利虽然也能降低HAPE患者的肺动脉压,但无统计学意义,而患者的体循环平均压在用药后显著下降,患者的病情分数也未见明显改善。结论:速尿能明显改善HAPE的临床症状,且有选择性地降低HAPE患者肺动脉高压的作用。

Objective： To evaluate the clinical curative effects of furosemide and captopril on patients with high altitude pulmonary edema（HAPE）. Methods： 10 patients with HAPE underwent Swan-Ganz catheter, the parameters of hemodynamies of these patients were measured before and after administration of furosemide and captopril. The clinical severity of HAPE was assessed by Lake Louis acute mountain sickness scoring system. Results： After using furosemide, mean pulmonary artery pressure（mPAP） and the Lake Louise scores of HAPE decreased significantly as compared with that before using this drug. The blood pressure, heart rate and cardiac output were not different before and after using furosemide. Although captopril could also decrease mPAP, but not significantly. The mean systemic arterial pressure （mSAP） of HAPE decreased significantly as compared with that before using captopril. Conclusion：Furosemide may improve the clinical symptoms of HAPE patients and reduce selectively their pulmonary hypertension without causing systemic vasodilation.