左肺反向循环逆转肺动脉高压的的机制

目的探讨左肺反向循环 (LLIC)逆转肺动脉高压的机制。方法选用杂种上海犬 8条 ,低氧 30min后行LLIC术。分别于术前、低氧 30min、LLIC完成时及完成后 2h行血流动力学指标、血气分析、NO和一氧化氮合成酶 (NOS)检测。结果平均肺动脉血压(MPAP)和心率 (HR)在低氧 30min和LLIC完成时明显高于术前和LLIC完成后 2h(P <0 .0 5 ) ;PaO2 、SaO2 、NO、NOS值在低氧 30min后和LLIC完成时明显低于术前和LLIC完成后 2h(P <0 .0 5 ) ;各项检测指标在术前和LLIC完成后 2h之间比较无显著差异 (P >0 .0 5 )。结论反向肺循环可能通过转换血气交换的解剖位置、提高血氧携带和增加NO的产生而逆转肺动脉高压

Mechanism of Left Lung Inverse Circulation Reversing Pulmonary Hypertension

Objective To study left lung inverse circulation (LLIC) reversing pulmonary hypertension(PH ) in canines. Methods Eight Shanghai mixed-breed dogs were chosen and LLIC was performed 30 min after hypoxia. Hemodynamics, blood gases, nitrous oxide(NO) and NO synthetase(NOS) were measured at pre-operation, 30 min post-operation, the end of LLIC and 2 h after LLIC. Results MPAP and HR had significant increase at 30 min post-operation and the end of LLIC compared with pre-operation and 2 h after LLIC (P<0.05). There was no statistical difference between 2 h after LLIC and pre-operation(P>0.05). PaO 2 , SaO 2, NO and NOS had significant decrease at 30 min post-operation and the end of LLIC compared with pre-operation and 2 h after LLIC (P<0.05), and 2 h after LLIC had no statistical difference with pre-operation(P>0.05). Conclusion LLIC may reverse PH through transfering anatomic site of blood gases exchange, and increase blood oxygen-carrying capacity and NO.