先天性心脏病并肺动脉高压患儿痰液及血液亚硝酸盐/硝酸盐的变化

目的探讨围手术期先天性心脏病(CHD)患儿痰液及血清亚硝酸盐/硝酸盐(NO2-/NO3-)变化及体外循环转流(CPB)和术后、外源性吸入一氧化氮(NO)对肺血管的影响。方法选择CHD并肺动脉高压(PH)患儿36例(A组),CHD未并PH患儿30例(B组),无CHD患者32例(C组)。3组术前及A、B组术后分别测定痰液及血清NO2-/NO3-,A组术后分别经NO吸入及静脉予硝普钠30 min,26、h测定痰液及血液NO2-/NO3-。结果术前痰液及血液NO2-/NO3-A组明显低于B、C组,术后A、B组痰液及血清NO2-/NO3-均减低,吸入NO后痰液NO2-/NO3-增加明显。相关分析示吸入NO后痰液和血液NO2-/NO3-呈明显正相关。结论吸入NO治疗对CHD并PH患儿效果更明显,反映在痰液和血液变化基本一致,对局部肺组织中NO2-/NO3-变化研究,痰液较血清标本更具针对性。

Changes of Sputum and Serum Nitrite/Nitrate in Children with Congenital Heart Disease Complicated with Pulmonary Hypertension

Objective To investigate the changes of sputum and serum nitrite /nitrate in children with congenital heart disease(CHD) complicated pulmonary hypertension and the effect on cardiopulmonary bypass(CPB),inhaled natric oxide(NO) on pneumoangiogram.Methods Twenty-six patients with CHD and PH were in experimental group as group A,30 patients with CHD and normal pulmonary arterial pressure were selected as group B and 32 patients without CHD as group C.The content of sputum and serum nitrite /nitrate was measured in 3 preoperative groups and postoperative group A and B,and the same results were measured in patients in pos-(toperative) group A at 30 min,2 h and 6 h after inhaling NO or transfusing sodium nitroprusside.Results The content of sputum and serum nitrite/nitrate in group A was lower than that in group B and C before operation and decreased postoperatively in group A and B,and increased after inhaling NO.There was significantly positive correlation of the content of nitrite /nitrate between in sputum and serum inhaled NO.Conclusions The effect on patients with CHD complicated PH is more obvious by the treatment of NO inhalation,which reflects the changes in serum corresponding with in sputum.Samples in sputum are more significant than those in serum.