左旋精氨酸对高原肺水肿患者血清一氧化氮合酶活性的影响

目的 探讨左旋精氨酸（L－Arg)对高原肺水肿（HAPE）治疗前后一氧化氮合酶（NOS）的影响。方法 在海拔3700m采用静脉滴注L－Arg治疗HAPE患者8例，并与吸入低浓度一氧化氮（NO）混合气治疗的8例HAPE患者作对照，分别检测血中NO及NOS含量。结果 吸入NO组和L－Arg组治愈后较治疗前NO，NOS均增高显著（P＜0．05或P＜0．01）；吸入NO组较L－Arg组治疗后NO及NOS均无统计学差异（P＞0．05）。结论 吸入NO和静滴L－Arg均可提高HAPE患者NOS活性，但L－Arg更经济简便，易于推广应用。

Effect of L-arginine on the activity of nitric oxide synthetase in patients with high altitude pulmonary edema

Objective To explore the effect of L-arginine(L-Arg) on plasma level of nitric oxide synthetase (NOS) in patients with high altitude pulmonary edema (HAPE). Methods In the clinic at 3 700 m altitude, 8 cases of HAPE were treated with L-Arg (20 g) intravenous instillation on the basis of routine treatment (L-Arg group), and other 8 cases of HAPE were treated with low concentration (0.001%) NO gas mixture inhalation (NO group) in addition to routine treatment. Their plasma levels of NO and NOS were examined before treatment and after recovery. Results As compared with those before treatment the plasma NO and NOS levels in patients after recovery were significantly increased both in Arg group and NO group (P<0.05, P<0.01). The differences between plasma NO and NOS levels of Arg group and NO group patients were non-significant before treatment and after recovery. Conclusion Both NO inhalation and L-Arg instillation can improve the plasma level of NOS in HAPE patients, and L-Arg instillation is more economical and easy to operate.