硝普钠和吸入NO降低缺氧性肺动脉高压的比较

Comparison of nitroprusside and NO inhalation in hypoxic pulmonary hypertension

目的 在缺氧性肺动脉高压模型上 ,研究硝普钠和吸入 NO之间的相互关系 .方法 健康杂种犬 8条 ,经 30 g·L- 1 戊巴比妥钠麻醉 ,建立血流动力学和呼吸气体监测体系 ,吸入气体由 O2 ,N2 和含 NO的 N2 组成 .每条犬按随机顺序确定先吸 NO或先静脉泵入硝普钠 ,先吸 NO时 ,降低 Fi O2 至0 .1 2 ,1 0 min后吸入 90μL· L- 1 NO,然后随机自股静脉泵入硝普钠 4μg· kg- 1 · min- 1 和 8μg· kg- 1 · min- 1 ,观察血流动力学参数较缺氧时变化率 ;先静滴硝普钠时 ,降低 Fi O2 至0 .1 2 ,按随机顺序自股静脉泵入硝普钠 4μg· kg- 1 · min- 1 和8μg· kg- 1 · m in- 1 ,然后分别吸入 90μL· L- 1 NO观察血流动力学参数较缺氧时的变化率 .结果 先吸 NO时 ,静脉泵入小剂量硝普钠 4μg· kg- 1 · min- 1 后 ,MPAP无显著差异 ,只降低 SVR,MAP及 CO,大剂量泵入硝普钠 8μg· kg- 1·min- 1 时 ,除 HR显著升高外 ,所有参数均显著下降 (P <0 .0 5 ) .先静脉泵入硝普钠时 ,吸入 90μL· L- 1 NO后 PAP及PVR较静脉泵入小剂量硝普钠 4μg· kg- 1· min- 1时显著下降 (P<0 .0 5 ) ,其余参数变化较轻 ,而吸入 90 μL· L- 1 NO后各参数与静脉泵入大剂量硝普钠 8μg· kg- 1· min- 1时无显著差异 .结论 吸入 NO?

AIM To study the active relationship of nitroprusside and inhaled nitric oxide in the model of hypoxic pulmonary hypertension dogs. METHODS The respiration of eight healthy dogs was controlled with ventilator and inspiratory gases were mixed with O 2, N 2 and NO in N 2. The hemodynamics and gases were monitored and recorded. The experiment was in two ways: in experiment A, NO was inhaled first while in experiment B, nitroprusside was administered first. In experiment A, when FiO 2 decreased to 0.12 and PAP was stable, 90 μL·L -1 NO was inhaled and then 4 μg·kg -1 ·min -1 and 8 μg·kg -1 ·min -1 niroprusside was infused at random. In experiment B, after FiO 2 was decreased to 0.12, nitroprusside of 4 or 8 μg·kg -1 ·min -1 was continuously infused in randomized order. When PAP was stable, 90 μL·L -1 NO was inhaled. The hemodynamics was observed. RESULTS In experiment A, low dose of nitroprusside didn’t significantly influence MPAP, but decreased SVR, MAP and CO. Large dose of that could significantly decrease MPAP. In experiment B, after 90 μL·L -1 NO was inhaled, PAP and PVR decreased significantly compared with 4 μg·kg -1 ·min -1 nitroprusside, but didn’t change compared with 8 μg·kg -1 ·min -1 nitroprusside. CONCLUSION 90 μL·L -1 NO inhaled and 4 or 8 μg·kg -1 ·min -1 nitroprusside infused influence each other. Low dose of nitroprusside and NO can decrease PAP and SVR and increase CO.