硫酸镁治疗实验动物缺氧性肺动脉高压

Magnesium sulfate in treatment of hypoxic pulmonary hypertension in experimental animal

目的 探讨硫酸镁治疗新生儿持续肺动脉高压 (PPHN)的疗效。方法 用 7只实验小猪吸入低浓度氧气造成急性缺氧性肺动脉高压模型来模拟PPHN。通过颈外静脉插入心导管 ,经右心室进入肺动脉检测肺动脉压力 (PAP)和心输出量等。通过股动脉插管检测体循环血压。同时测心率、血氧饱和度、血气分析和血镁浓度。结果 实验小猪缺氧 10min后肺动脉收缩压 (SPAP)升高 (4 2 .1± 19.4) % (P <0 .0 1) ,舒张压 (DPAP)和平均肺动脉压 (MPAP)分别升高 (4 6 .8± 2 3.9) %和 (39.7± 2 2 .1) % (P <0 .0 1)。滴注硫酸镁后SPAP下降(2 5 .2± 5 .4) % (P <0 .0 1) ,DPAP和MPAP分别下降 (2 5 .5± 6 .3) %和 (2 2 .5± 5 .3) % (P <0 .0 1)。体循环收缩压无明显改变。血镁浓度明显升高。结论 硫酸镁能显著降低肺动脉高压 。

Objective To evaluate the effects of magnesium sulfate (MgSO 4) in the treatment of persistent pulmonary hypertension of newborn (PPHN). Methods Hypoxia-induced pulmonary hypertension models of seven piglets were constructed. A catheter was inserted through the external jugular vein and advanced to the right atrium, right ventricle and into the pulmonary artery to measure pulmonary arterial pressure (PAP) and cardiac output (CO). Another catheter was inserted into the right femoral artery to measure systemic arterial pressure (SAP). Heart rate (HR), arterial oxygen saturation (SaO 2), arterial blood gases, and serum magnesium (Mg ) concentrations were estimated. Results After hypoxia was induced for 10 minutes, there were significant increases in systolic PAP (SPAP), diastolic PAP (DPAP) and mean PAP (MPAP) (42.1%±19.4%, 46.8%±23.9% and 39.7%±22.1% respectively; P <0.01). Post MgSO 4 infusion, significant decreases occurred in SPAP, DPAP and MPAP (25.2%± 5.4%, 25.5%±6.3% and 22.5%±5.8% respectively; P <0.01), while systolic SAP remained unchanged ( P > 0.05), but serum Mg  rose significantly from (0.79±0.12) mmol/L to (2.78±1.11) mmol/L following the infusion of MgSO 4. Conclusion Magnesium sulfate decreases PAP significantly and improves PO 2 with less effect on the SAP, HR and CO.