L-精氨酸对高原肺水肿患者血液流变学的作用

目的：探讨雾化吸入左旋精氨酸（L-Arg）对高原肺水肿患者血液流变学的影响。方法：在海拔3700m高原，采用氧气驱动雾化吸入L-Arg，治疗高原肺水肿（HAPE）患者9例（L-Arg组），将吸入低浓度一氧化氮（NO）混合气治疗的另外8例高原肺水肿患者（NO组）作对照，分别测定患者的红细胞压积（HCT）、血液粘度（ηb）、血浆粘度（ηp）、还原粘度（ηr）、红细胞刚性指数（IR）、红细胞变形系数（TK）、红细胞聚集系数（VAI）和血栓形成系数（TFL）等血液流变学指标。结果：NO组和L-Arg组治疗后较治愈前ηb、ηp、ηr、VAI、TFL均降低显著（P〈0．05～0．01），而HCT、TK、IR无统计学差异（P〉0．05）；NO组与L-Arg组比较，各指标均无统计学差异（P〉0．01）。结论：L-Arg治疗HAPE有效，通过提高NO水平而改善血液循环，且经济简便，易于推广应用。

Effects of L-arginine on metabolism of hemorheology in patients with high altitude pulmonary edema

Objective:To study the effects of L - a rginine(L - Arg) on metabolism of hemorheology in patients with high altitude p ulmonary edema(HAPE). Methods: 8 patients with HAPE were cur ed by inhaling L - Arg at 3700 m altitude. The contents of HCT, hb, hP, hr, IR, TK VAI and TFL in their plasma were determined after treatment. The cured resul ts were compared with those of another 8 cases cured by inhaling nitric oxide(NO ). Results: The contents of hb, hP, hr, VAI and TFL of both groups decreased notably( (P<0.01), but HCT, TK and IR did not change stat istically(P>0.05). Compared NO group with L - Arg group, no significant d ifference of above indexes was found (P>0.05). Conclusion: Inhalation of L - Arg can improve blood circulation of HAPE patients and t reat effectively HAPE. Meanwhile, Inhalation of L - Arg is easier and safer tha n inhalation of NO; it is worthy to be generalization.