吸入一氧化氮治疗肺动脉高压的量-效关系

目的探讨吸入一氧化氮（ＮＯ）治疗肺动脉高压的量－效关系。方法用右心导管检查术测定血流动力学与心功能指标,观察吸入２０、４０、６０和８０ｐｐｍ不同浓度ＮＯ对１６例肺动脉高压患者血流动力学和心功能的作用。结果吸入２０、４０、６０和８０ｐｐｍＮＯ均有显著降低肺动脉高压和肺血管阻力的作用。吸入２０ｐｐｍＮＯ即达到最大扩血管效应,肺动脉平均压和肺血管阻力分别降低２６．５％和４０．３％（Ｐ＜０．０００１）;增加吸入ＮＯ的浓度,肺动脉压力和肺血管阻力不再进一步降低。结论患者吸入ＮＯ的最佳浓度以不超过２０ｐｐｍ为宜。

The effect of nitric oxide administration on pateints with pulmonary hypertension: a dose-response study

Objective To explore the dose response relationship in patients with pulmonary hypertension after inhalation of nitric oxide (NO). Methods the effect of various concentrations (20, 40, 60 and 80 ppm) of NO on hemodynamics and cardiac function in 16 patients with pulmonary hypertension was studied with right heart catheterization. Results Pulmonary artery pressure and pulmonary vascular resistance reduced significantly after inhalation of various concentrations (20, 40, 60 and 80 ppm) of NO. The vascular response to NO was not concentration dependant with a maximal effect obtained at 20ppm. At inhalation of low dose of NO (20ppm), the mean pulmonary artery pressure and pulmonary vascular resistance dropped by 26.5% and 40.3% ( P< 0.0001), respectively. With the increase of inhaled NO concentration, pulmonary artery pressure and pulmonary vascular resistance did not decline. Conclusion The best concentration of inhaled NO was not more than 20 ppm in the patients of this study.