双心房输注前列腺素E1和去氧肾上腺素对急性肺动脉高压犬血流动力学的影响

Effects of biatrial infusion of PGE1 and phenylephrine on hemodynamics in dogs with acute pulmonary hypertension

目的观察双心房输注前列腺素E1和去氧肾上腺素对急性肺动脉高压犬血流动力学的影响。方法 15只杂种犬建立急性肺动脉高压模型后,随机均分为三组。A组通过Swan-Ganz导管至右心房给予前列腺素E120ng·kg-1.min-1,通过左心导管至左心房给予去氧肾上腺素2μg·kg-1.min-1;B组经右心房给予和A组同样的两种药物和剂量;C组经右心房给予等容积的生理盐水。记录麻醉前(T0)、建模成功后10min(T1)、20min(T2)、给药后10min(T3)、30min(T4)、60min(T5)的HR、MAP、SpO2、CVP、平均肺动脉压(MPAP)、肺毛细血管楔压(PCWP)和心输出量(CO),计算心脏指数(CI)、肺循环阻力指数(PVRI)和体循环阻力指数(SVRI)。结果与C组比较,A、B组T3～T5时MPAP降低(P<0.05);与A组比较,B组T3～T5时CI、MAP和SVRI降低(P<0.05)。结论双心房分别输注前列腺素E1和去氧肾上腺素能降低急性肺动脉高压犬的MPAP,改善心功能。

Objective To observe the effects of biatrial infusion prostaglandin E1 （PGE1） and phenylephrine on hemodynamics in dogs with acute pulmonary hypertension. Methods Fifteen dogs were equally randomized into 3 groups after establishing acute pulmonary hypertension models. PGE1 20 ng·kg^-1·min^-1 via right atrium by Swan-Ganz catheter and phenylephrine 2 μg·kg-1·min-1 via the catheter in the left atrium were given in group A. The same drugs and doses were also given via the right atrium in group B. The same volume of normal saline was given via right atrium in group C. HR, MAP, SpO2, CVP, mean pulmonary artery pressure （ MPAP）, pulmonary capillary wedge pressure （PCWP） ,and cardiac output （CO） were measured before anesthesia（T0 ）,at 10 min（T1 ） and 20 rain （T2） after modeling, and 10 min（T3 ）, 30 min（T4 ）, 60 min（T5） after administration. Cardiac index （CI）, pulmonary vascular resistance index （PSVI）, systemic vascular resistance index（SVRI） were calculated. Results Compared with group C, MPAP decreased at T3-T5 in groups of A and B（P〈0.05）. Compared with group A, CI, MAP, and SVRI decreased at T3-T5 in group B（P〈0.05）. Conclusion Biatrial infusion of PGE1 and phenylephrine can reduce MPAP and improve cardiac function in dogs with acute pulmonary hypertension.