氨茶碱及硝苯吡啶治疗高原肺水肿效果观察

HEMODYNAMIC EFFECTS OF AMINOPHYLLINE AND NIFEDIPINE IN PATIENTS WITH HIGH ALTITUDE PULMONARY EDEMA

目的 :评价氨茶碱及硝苯吡啶对高原肺水肿的疗效。方法 :采用右心漂浮导管方法 ,观察了静脉推注氨茶碱及舌下含服硝苯吡啶对患者血流动力学及动脉血气等方面的影响。结果 :氨茶碱能降低患者的肺动脉压和肺血管阻力 ,提高患者的心输出量及动脉血氧饱和度 ,用药前后体循环压及心率未见明显变化。硝苯吡啶含服也能降低肺动脉压和肺血管阻力 ,虽能降低体循环压但幅度较小 ,但用药前后心输出量、心率及动脉血气饱和度未见明显变化。结论 :氨茶碱及硝苯吡啶均有急性降低高原肺水肿患者肺动脉高压的作用 ,但二者相比 ,氨茶碱降低肺动脉压效果明显优于硝苯吡啶。

Aim: To evaluate the hemodynamic effects of aminophylline and nifedipine in patients with HAPE. Methods: 10 patients with HAPE undergone Swan-Ganz catheter. The parameters of hemodynamics and arterial blood gases in HAPE were measured before and after administration of nifedipine 20 mg sublingually and aminophylline 0.25 g intravenously respectively. Results: After administering 0.25 g aminophylline the mPAP and PVR significantly decreased,the cardiac output and the level of PaO 2,SaO 2 increased obviously,the mSAP,HR did not change so much. After using 20 mg nifedipine,the mPAP,PVR and mSAP also decreased,while the cardiac output,HR and the level of PaO 2,SaO 2 did not show any changes. Conclusion: Both of aminophylline and nifedipine can attenuate pulmonary hypertension in patients with HAPE,but the effect of aminophylline was better than the effect of nifedipine.