L-精氨酸治疗高原肺水肿患者的临床疗效及对血流动力学变化的影响

Clinical effects of L-arginine in patients with high altitude pulmonary edema and its hemodynamic changes

目的 评价L -精氨酸对高原肺水肿患者的疗效及机制。方法 采用右心漂浮导管的研究方法 ,观察了静滴L -精氨酸对患者血流动力学及动脉血气等方面的影响 ,同时采用Lake评分法对患者的病情进行定量评估。结果 L -精氨酸能降低HAPE患者的肺动脉压和肺血管阻力 ,能提高患者动脉氧分压及血氧饱和度 ,而对体循环及心率未见明显影响 ;应用L -精氨酸后 ,HAPE患者病情定量分数亦明显低于用药前。结论 L -精氨酸能明显改善HAPE的临床症状 ,且有明显降低HAPE患者肺动脉高压的作用。

ObjectiveTo evaluate the clinical effects of L-arginine in patients with HAPE.Methods8 patients with HAPE underwent Swan-Ganz catheter;the parameters of hemodynamics and arterial blood gases in HAPE were measured before and after administration of L-arginine;the clinical severity of HAPE was assessed by using the Lake Louise acute mountain sickness scoring system.ResultsAfter injecting intravenously L-arginine,the mPAP,PVR of HAPE decreased significantly as against that prior to injection;the lake louise scores of HAPE also decreased significantly as against the values prior to injection;the PaO 2 and SaO 2 of HAPE were increased;the blood pressure ,heart rate were not different before and after injecting L-arginine.ConclusionL-arginine may improve the clinical symptoms of the patients with HAPE;It also can selectively decline the pulmonary hypertension in HAPE without causing systemic vasodilation.