硫酸镁治疗缺氧小猪肺动脉高压的实验研究

Experimental study on the treatment of the hypoxic pulmonary hypertension in the piglets with magnesium sulfate

为探讨硫酸镁治疗新生儿持续肺动脉高压 (PPHN)的疗效 ,以12只实验小猪吸入低浓度氧气造成缺氧性肺动脉高压模型模拟PPHN。通过颈外静脉插入心导管 ,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 ,同时检测心率、血氧饱和度 (SaO2)、血气分析和血镁浓度。结果显示 ,实验小猪缺氧10分钟后肺动脉收缩压 (SPAP)升高53.5%±25.4% (P<0.001) ,舒张压 (DPAP)和平均肺动脉压 (MPAP)分别升高57.1%±31.0%和50.6%±27.8% (P<0.001) ;静脉滴注硫酸镁后SPAS下降24.1 %±5.0 % (P<0.001) ,DPAP和MPAP分别下降22.7 %±7.2 %和19.8%±6.4% (P<0.001)。SaO2 和血氧分压均有升高。体循环血压也有下降 ,但下降幅度较小且与剂量有关。心率有轻度降低 ,心输出量无改变。血镁浓度明显升高 ,从0.79±0.14mmol/L升高至2.74±0.96mmol/L(P<0.001)。提示硫酸镁能显著降低肺动脉高压 ,改善血氧分压 ,对体循环血压、心率及心输出量影响较小 ,而且价格便宜 ,使用方便 ,值得在PPHN治疗中提倡。

In order to evaluate the effects of magnesium sulfate(MgSO 4 )on the treatment of newborn infants with persistent pulmonary hypertension(PPHN),hypoxic pulmonary hypertension model mimic PPHN was induced in12piglets with aspiration of low concentration oxygen.A catheter was inserted through the external jugular vein,then advanced to the right atrium,right ventricle and enter the pulmonary artery to measure the pulmonary arterial pressure(PAP)and cardiac output(CO).Another catheter was inserted into the right femoral artery to measure the systemic arterial pressure(SAP).At the same time,the heart rate(HR),arterial oxygen saturation(SaO 2 ),arterial blood gases and magnesium level in serum were also recor_ ded.The results showed when hypoxia was induced for10minutes the levels of the systolic PAP(SPAP),dia_ stolic PAP(DPAP)and mean PAP(MPAP)were significantly increased(53.5%±25.4%,57.1%±31.0%and50.6%±27.8%respectively,P<0.001).After MgSO 4 was intravenously infused the level of SPAP,DPAP and MPAP were significantly decreased(24.1%±5.0%,22.7%±7.2%and19.8%±6.4%respectively,P<0.001)with SaO 2 and PO 2 increased,(P<0.05),while the systolic SAP,diastolic SAP and mean SAP were decreased(10.7%±8.9%,18.3%±11.3%and16.0%±8.0%respectively,P<0.01)depending on the dosage of MgSO 4 given.Serum Mg ++ level significantly rose from0.79±0.14mmol/L to2.74±0.96mmol/L following the MgSO 4 infusion while HR and CO had little changes,indicating magnesium sulfate can decrease the PAP significantly and improve PO 2 with less effect on the SAP,HR and CO.So it's worth of recommending to apply MgSO 4 in the treatment of newborn infants with PPHN in our country as it is low cost and easy to apply.