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目的探讨硝普钠雾化吸入对肺源性心脏病(肺心病)患者肺动脉高压的影响。方法选择慢性肺心病肺动脉高压患者30例,静息测量肺动脉压、左心室射血分数,水银柱血压计测量肱动脉平均动脉压;而后行生理盐水雾化吸入20min,停吸10min;再行硝普钠雾化吸入(1.0g/L)20min;分别于两者吸入5、10、15、20min以及停吸5、10min时测量上述各项指标,并进行比较分析。结果生理盐水雾化吸入全程各指标无明显变化。硝普钠雾化吸入5min时,肺动脉压由(66.76±10.24)mmHg降至(56.44±11.22)mmHg(P<0.01);左心室射血分数由0.50±0.04升至0.56±0.06(P<0.01);10min时,肺动脉压继续下降至(53.26±10.62)mmHg(与5min时比较,P<0.01);左心室射血分数继续上升至0.58±0.06(与5min时比较,P<0.01);吸入至20min,肺动脉压、左心室射血分数与10min比较无明显变化;停止吸入5min,肺动脉压即回升至(63.22±10.44)mmHg,左心室射血分数降至0.53±0.04(P<0.01);停吸10min均恢复至吸入前状态。平均动脉血压全程无明显变化。结论硝普钠雾化吸入可明显降低肺心病患者肺动脉压,提高左心室射血分数,但对平均动脉血压无明显影响。
Objective To investigate the effects of inhalation of sodium nitroprusside on pulmonary hypertension in patients with pulmonary heart disease (pulmonary heart disease). Methods Thirty patients with chronic pulmonary heart disease with pulmonary hypertension were selected. Pulmonary artery pressure, left ventricular ejection fraction, and mercury sphygmomanometer were used to measure the mean arterial pressure of the brachial artery. After inhalation of normal saline for 20 minutes and inhalation for 10 minutes, Sodium nebulization (1.0g / L) 20min; respectively inhaled 5,10,15,20min both and stop sucking 5,10min measured when the above indicators, and comparative analysis. Results saline inhalation throughout the whole process no significant change in each indicator. Pulmonary arterial pressure decreased from (66.76 ± 10.24) mmHg to (56.44 ± 11.22) mmHg after inhaled sodium nitroprusside for 5 min (P <0.01); left ventricular ejection fraction increased from 0.50 ± 0.04 to 0.56 ± 0.06 (P <0.01) ); Pulmonary arterial pressure continued to decrease to (53.26 ± 10.62) mmHg at 10 min (P <0.01 vs 5 min); left ventricular ejection fraction continued to increase to 0.58 ± 0.06 (P <0.01 vs. 5 min) Pulmonary arterial pressure and left ventricular ejection fraction did not change significantly compared with 10 min at 20 min. Pulmonary arterial pressure rose to (63.22 ± 10.44) mmHg and left ventricular ejection fraction decreased to 0.53 ± 0.04 (P <0.01) after 5 min of inhalation. Stop breathing 10min were restored to the state before inhalation. Mean arterial blood pressure throughout the whole no significant change. Conclusion The inhalation of sodium nitroprusside can significantly reduce pulmonary artery pressure in patients with pulmonary heart disease, improve left ventricular ejection fraction, but no significant effect on the mean arterial pressure.