抗胆碱药治疗高原肺水肿患者的临床研究

目的评估抗胆碱药对高原肺水肿（ＨＡＰＥ）的临床疗效及探讨其作用机制。方法将海拔４７００～５２６０米地区５８２例高原肺水肿患者分为３９３例抗胆碱药治疗组和１８９例一般疗法治疗的对照组，在治疗前及治疗后２４小时（ｈ）作无创血液动力学检测。结果抗胆碱药组患者的症状、体征、Ｘ线平片肺部阴影消失时间分别为（３３±１７）ｈ、（４６±２２）ｈ、（７５±２９）ｈ，平均住院日为（５３±１９）ｄ，与对照组比较差异有显著性（Ｐ均＜０．００１），治愈率显著提高（Ｐ＜０．０５），１４项血液动力学参数的异常改变得到纠正（Ｐ＜０．０５或Ｐ＜０．０１）。结论抗胆碱药具有疗效确切，疗程短，副作用小，治愈率高等突出优点。对血液动力学的作用为其重要的治疗机制之一，可作为高原肺水肿现场治疗的重要药物。

Study on anticholinergics for the treatment of high altitude pulmonary edema

OBJECTIVE: To evaluate the clinical effects and mechanism of anticholinergics in treating high altitude pulmonary edema (HAPE). METHODS: 582 patients with HAPE (in 4700-5260 m) were divided into 2 groups: one group (393 patients) was treated with anticholinergic (Group A), and the other 189 cases were treated with a general therapy without anticholinergic (Grorp B). RESULTS: Compared with Group B, the average admitted days were reduced, the symptom, physical and X-ray signs disappeared more quickly (P < 0.001), the cure rate was raised clearly (P < 0.05) in Group A and the abnormal changes of hemodynamics had been adjusted (P < 0.05, P < 0.01). CONCLUSIONS: Anticholinergic used for HAPE has a rapid and exact curative effect, a slight side effect, and a shorten course of treatment.