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本研究的目的即通过动物实验 ,观察一氧化氮作为支气管扩张剂解除气道痉挛的作用及对肺内气体交换的影响 ,以及同时吸入一氧化氮和氦 氧混合气对哮喘的作用。方法 :选取 12只雄性杂种犬采用交叉设计、自身对照的方法进行实验 ,采用向气管内注入乙酰甲胆碱的方法使气道平滑肌痉挛。气道激发后观察吸入10 0× 10 -6的一氧化氮以及同时吸入一氧化氮和氦 氧混合气对吸气阻力、肺动脉压和肺内气体交换的影响。结果 :气道激发后吸气阻力、肺动脉压显著增高 ,呼吸系有效顺应性和动脉血氧分压明显下降 ,动 静脉分流增加伴随二氧化碳潴留。吸入 10 0× 10 -6一氧化氮能够降低气道阻力及肺动脉压 ,但对有效肺顺应性、动 静脉分流、动脉血氧分压、二氧化碳分压的影响不大。然而将一氧化氮与氦 氧混合气混合同时吸入 ,与单纯吸入一氧化氮比较 ,气道阻力进一步下降 ,有效肺顺应性、动脉血氧分压明显增加 ,动 静脉分流和动脉血二氧化碳分压显著下降。结论 :吸入较高浓度的一氧化氮能够对抗由乙酰甲胆碱引起的气道痉挛以及由缺氧引起的肺动脉压增高 ,但不能明显改善肺内气体交换。同时吸入氦 氧混合气后不但能进一步的降低气道阻力 ,而且对呼吸系有效顺应性、动 静脉分流以及动脉血氧分压、二氧化碳分压有明显的改
The purpose of this study is to observe the effect of nitric oxide as a bronchodilator on airway spasm and the effect on gas exchange in the lung by animal experiments and the effect of inhaling nitric oxide and helium-oxygen mixture on asthma. Methods: Twelve male mongrel dogs were selected and tested by crossover design and self-control method. Airway smooth muscle spasm was induced by intratracheal injection of methacholine. After airway excitation, the effects of inhaling nitric oxide at a dose of 10 × 10 -6 and simultaneous inhalation of nitric oxide and helium-oxygen mixture on inspiratory resistance, pulmonary arterial pressure and intrapulmonary gas exchange were observed. Results: The inspiratory resistance and pulmonary arterial pressure were significantly increased after airway challenge. The effective compliance of respiratory system and arterial partial pressure of oxygen decreased obviously. The arteriovenous shunt increased with carbon dioxide retention. Inhalation of 10 × 10 -6 nitric oxide can reduce airway resistance and pulmonary arterial pressure, but has little effect on effective pulmonary compliance, arteriovenous shunt, arterial partial pressure of oxygen and partial pressure of carbon dioxide. However, the combination of inhalation of nitric oxide and helium-oxygen mixture at the same time, compared with simple inhalation of nitric oxide, further decreased airway resistance, effective pulmonary compliance, arterial oxygen pressure increased significantly, arteriovenous shunt and arterial partial pressure of carbon dioxide Decreased significantly. CONCLUSIONS: Inhalation of higher concentrations of nitric oxide can counteract airway spasm caused by methacholine and increased pulmonary arterial pressure caused by hypoxia, but does not significantly improve gas exchange in the lungs. At the same time inhalation of helium-oxygen mixture will not only further reduce airway resistance, and effective compliance of the respiratory system, arteriovenous shunt and arterial partial pressure of oxygen, carbon dioxide partial pressure significantly changed