伊洛前列素对缺氧性肺动脉高压自由基代谢的影响

Effects of iloprost on free radical metabolism of patients with hypoxia induced pulmonary hypertension6

目的研究雾化吸入伊洛前列素对缺氧性肺动脉高压(HPH)患者自由基代谢的影响。方法在海拔3700 m、4300 m、5200 m和5380 m高原,对56例HPH患者采用雾化吸入伊洛前列素5μg 1次,吸药前、吸入后即刻采血检测超氧化物歧化酶(SOD)、丙二醛(MDA)、乳酸(BLA)、一氧化氮(NO)及其合酶(NOS)的含量。结果吸入后较吸入前,在海拔3700 m,SOD(90.50±7.13)U/ml vs(73.00±10.51)U/ml、NO(73.64±13.42)μmol/L vs(49.60±11.31)μmol/L、NOS(90.50±7.13)U/ml vs(73.00±10.51)U/ml增高,MDA(4.23±0.71)nmol/ml vs(5.61±1.13)nmol/ml、BLA(1.27±0.25)mmol/L vs(1.79±0.62)mmol/L降低,有非常显著差异(P<0.01);在海拔4300 m,SOD(86.78±5.12)U/ml vs(69.39±4.59)U/ml、NO(73.51±6.37)μmol/L vs(48.79±3.76)μmol/L、NOS(44.60±2.64)U/ml vs(40.23±2.31)U/ml增高,MDA(4.24±0.80)nmol/ml vs(6.44±1.51)nmol/ml、BLA(1.46±0.28)mmol/L vs(1.89±0.28)mmol/L降低,有显著差异(P<0.05或P<0.01);在海拔5000 m以上,SOD(86.46±9.05)U/ml vs(66.00±9.95)U/ml、NO(65.50±8.32)μmol/L vs(47.62±11.38)μmol/L、NOS(37.06±2.22)U/ml vs(33.18±2.99)U/ml增高,MDA(6.42±1.59)nmol/ml vs(8.24±2.09)nmol/ml和BLA(2.46±1.24)mmol/L vs(5.18±1.48)mmol/L降低,有非常显著差异(P<0.01)。结论伊洛前列素可改善HPH患者肺氧合效应,增强机体抗氧化酶活性和乳酸清除能力。

Objective To study the effects of aerosol inhalation of iloprost on free radical metabolism of patients with hypoxia induced pulmonary hypertension（HPH）.Methods At the high altitude of 3,700 m,4,300 m,5,200 m and 5,380 m above the sea level,56 patients with HPH took the aerosol inhalation of 5 μg iloprost for once.Before and after the inhalation,their blood samples were obtained to detect the contents of superoxide dismutase（SOD）,malondialdehyde（MDA）,blood lactic acid（BLA）,nitric oxide（NO）and nitric oxide synthase（NOS）.Results Compared with the situation before the inhalation at the altitude of 3,700 m,the subjects’ SOD [（90.50±7.13）U/ml vs（73.00±10.51）U/ml],NO [（73.64±13.42）μmol/L vs（49.60±11.31）μmol/Land NOS [（90.50±7.13）U/ml vs（73.00±10.51）U/mlincreased and MDA [（4.23±0.71）μmol/L vs（5.61±1.13）μmol/Land BLA [（1.27±0.25）mmol/L vs（1.79±0.62）mmol/Ldecreased after the inhalation,and the differences were very significant（P〈0.01）.For people at the altitude of 4,300 m,their SOD [（86.78±5.12）U/ml vs（69.39±4.59）U/ml],NO [（73.51±6.37）μmol/L vs（48.79±3.76）μmol/Land NOS [（44.60±2.64）U/ml vs（40.23±2.31）U/mlincreased and MDA [（4.24±0.80）nmol/ml vs（6.44±1.51）nmol/mland BLA [（1.46±0.28）mmol/L vs（1.89±0.28）mmol/Ldecreased after the inhalation,and the differences were significant（P〈0.05 or P〈0.01）.For people at the altitude above 5,000 m,their SOD [（86.46±9.05）U/ml vs（66.00±9.95）U/ml],NO [（65.50±8.32）μmol/L vs（47.62±11.38）μmol/Land NOS [（37.06±2.22）U/ml vs（33.18±2.99）U/mlincreased and MDA [（6.42±1.59）nmol/ml vs（8.24±2.09）nmol/mland BLA [（2.46±1.24）mmol/L vs（5.18±1.48）mmol/Ldecreased after the inhalation.There also were significant differences between the indexes before and after the inhalation（P〈0.01）.Conclusion Iloprost can improve the lung oxygenation of patients with HPH and strengthen the abilities of antioxidase and lactate clearance in the body.