慢性阻塞性肺疾病患者呼出气NO含量的变化及吸入NO对其肺功能的影响

为探讨一氧化氮 (NO)在慢性阻塞性肺疾病 (COPD)发病中的作用及吸入NO对COPD肺功能的影响 ,本研究检测了COPD患者鼻、口呼出气中NO的含量及吸入不同浓度 (10～ 80ppm)NO时肺功能和血气指标。结果表明 :COPD患者鼻、口呼出气NO含量均明显低于对照组 (P <0 .0 1) ,且COPD和对照组口呼出气NO含量低于鼻呼出气 (P <0 .0 1) ;吸入 2 0～ 80ppmNO能明显改善COPD患者部分肺通气功能指标(FEV1、FEV1/FVC、FEV1%、PEF) ,且呈效量依赖关系 ,但对肺容量和肺弥散功能指标无明显影响 ;吸入NO后COPD患者PaCO2 增加 ,但对PaCO2 和高铁血红蛋白无明显影响。提示NO合成减少可能介导了COPD的发病 ,吸入一定浓度的NO可改善COPD患者肺通气功能和PaO2

The Changes in Exhaled Endogenous NO of Patients with Chronic Obstructive Pulmonary Disease and the Effects of Inhaled NO on Pulmonary Function

WT5BZ]To investigate the role of nitric oxide(NO) in pathogenesis of chronic obstructive pulmonary disease(COPD) and the effects of inhaled NO on pulmonary function of patients with COPD. In this study, exhaled NO was continuously measured by chemiluminescence technique during normal tidal breathing through the nose or mouth,and the pulmonary function index were monitored after inhalation of 10-80 ppm NO in 18 patients with COPD and 12 control subjects.The results showed that the nose and mouth exhaled NO levels in COPD were significantly lower than those in control group (P<0.01),the mouth exhaled NO level was lower than the nose in both COPD and control groups (P<0.01).Inhalation of 20-80 ppm NO could markedly increase some pulmonary ventilation function index (e.g.FEV 1/FVC,FEV 1%, PEF) with a dose-dependant relationship as well as could increase PaO 2,but could not affect the index of lung volume,lung diffusion function,PaCO 2 and plasma methemoglobin level in COPD patients.It is suggested that a decrease of endogenous NO may regulate pathogenesis of COPD, and inhaled low dose NO can improve pulmonary function and PaO 2 of patients with COPD.