一氧化氮治疗吸入性损伤肺动脉高压量效关系的实验研究

Doseeffect of inhaled nitric oxide on pulmonary hypertension in inhaled injury in rabbits

目的探讨吸入不同浓度一氧化氮（ＮＯ）治疗兔烟雾吸入性损伤肺动脉高压的量效关系。方法用右心导管检查术连续测定血流动力学指标，观察吸入体积分数为（１、５、１０、２０、３０、４０、５０、６０）×１０－６的ＮＯ对１５只兔烟雾吸入所致肺动脉高压血流动力学的作用。结果吸入（１、５）×１０－６的ＮＯ对平均肺动脉压（ｍＰＡＰ）、肺毛细血管楔压（ＰＣＷＰ）、肺微血管压（Ｐｍｖ）和肺血管阻力（ＰＶＲ）无明显作用（Ｐ＞００５）；吸入（１０、２０、３０、４０、５０、６０）×１０－６的ＮＯ均有降低ｍＰＡＰ、ＰＣＷＰ、Ｐｍｖ的作用（Ｐ＜００５，Ｐ＜００１）；吸入３０×１０－６的ＮＯ即达到最大扩血管效应（Ｐ＜００５，Ｐ＜００１），再增加吸入ＮＯ的浓度，ＰＶＲ不再进一步降低（Ｐ＞００５）。结论吸入ＮＯ降低烟雾吸入性损伤早期肺动脉压的体积分数以不超过３０×１０－６为宜。

Objective To explore the relation of doseresponse of NO inhalation in treatment of pulmonary hypertension in rabbits with smoke inhalation injury. Methods The effect of various concentrations(1,5,10,20,30,40,50 and 60)10-6 of NO on pulmonary hypertension after smoke inhalation injury was studied with right heart catheterization in 15 rabbits. ResultsZMean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP),pulmonary minute vessel pressure (Pmv), and pulmonary vascular resistance (PVR) were not changed remarkably (P>005) after inhalation of(1 or 5)10-6 NO. mPAP,PCWP, and Pmv were lowered significantly after inhalation of (10,20,30,40, 50 and 60)10-6 NO (P<005,P<001). Major vascular relaxation occurred when NO concentration was at 3010-6, and PVR did not further decrease along with the increase of NO concentration. Conclusion The concentration of inhaled NO should not exceed 3010-6 for the treatment of pulmonary hypertension in early stage of smoke inhalation.