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Effect of nitric oxide in children with pulmonary hypertension

一氧化氮对儿童肺动脉高压的影响

基本信息

批准号：
08670929
负责人：
AKAGI Teiji
金额：
$ 1.22万
依托单位：
Kurume University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

项目摘要

1.Establishment of a animal moldel of persistent pulmonary hypertension of the newborn In 15 newborn piglets, pulmonary artery pressure was continuously measured by the catheter which was inserted from the internal jugular vein. At this condition, low concentration oxygen (FiO2<15%) was administer to increase the pulmonary pressure. In the condition under the hypooxgenation and hypercapnia, pulmonary arterial pressure of newborn piglet within 48 hours after birth was almost equal to systemic arterial pressure, and right to left shunt was present. Most of all animal model died within 7 days under this condition (FiO2<15%) due to decreasing of systemic arterial pressure. On the other hand, in 4 newborn piglets who were administered indometacin in the uterus, pulmonary artery pressure was within 60% of systemic arterial pressure.2.Evaluation of pulmonary vascular response for inhaled nitric oxide in patients with pulmonary hypertension Low dosage nitric oxide (5-10ppm) was inhaled in patients with congenital heart disease complicated with pulmonary hypertension, and the change of pulmonary vascular resistance was measured. Such effectiveness was compared to that of high concentration oxygen. Additionally, the effectiveness of nitric oxide under the different degree of pulmonary hypertension was investigated. In severe pulmonary hypertension such as Eisenmenger syndrome, both high concentration oxygen and the normal oxygen with nitric oxide showed no affect on the hemodynamical variables. In patients moderate pulmonary hypertension, pulmonary artery pressure and pulmonary vascular resistance both significantly decreased with high oxygen and with the nitric oxide inhalation, but these decreases were not found in patients with normal pulmonary pressure. Our data suggested that inhaled nitric oxide, even in a low dosage, was a potent and selective pulmonary vasodilator in patients with congenital heart disease complicated with pulmonary hypertension.

1.新生仔猪持续性肺动脉高压动物模型的建立新生仔猪15只，经颈内静脉插管，连续测量肺动脉压。在此条件下，给予低浓度氧气(FiO2&lt；15%)以增加肺动脉压。在低氧高二氧化碳条件下，新生仔猪出生后48h内的肺动脉压与体动脉压基本相等，存在右向左分流。大多数动物模型在这种情况下(FiO2和Lt；15%)在7天内死亡，原因是体动脉压降低。另一方面，宫内注射吲哚美辛的4头新生仔猪的肺动脉压均在体动脉压的60%以内。2.肺动脉高压患者吸入一氧化氮的肺血管反应评价先天性心脏病合并肺动脉高压患者吸入小剂量一氧化氮(5~10ppm)，测定肺血管阻力的变化。将这种效果与高浓度氧气的效果进行了比较。此外，还观察了一氧化氮在不同程度的肺动脉高压下的作用。在重度肺动脉高压如艾森门格综合征中，高浓度氧和常氧加一氧化氮对血流动力学指标均无影响。中度肺动脉高压患者在高氧和吸入一氧化氮后，肺动脉压和肺血管阻力均显著降低，而正常肺动脉压患者则无此变化。我们的数据表明，吸入一氧化氮，即使是低剂量，在先天性心脏病合并肺动脉高压患者中也是一种有效的选择性肺血管扩张剂。