硝酸甘油雾化吸入对肺源性心脏病发作患者血管内皮功能的影响

摘要

目的：探讨硝酸甘油雾化吸入对肺源性心脏疾病发作患者血管内皮功能的影响。方法：在我院就诊的94例肺源性心脏病发作患者，随机分成常规治疗组和雾化吸入组（常规治疗基础上加用硝酸甘油雾化吸入），每组47例。观察治疗前后平均肺动脉压（mPAP）、血气分析及临床症状积分情况，评价疗效。结果：治疗后，与常规治疗组比较，雾化吸入组 mPAP [（27.97±3.42）mmHg 比（23.21±3.34）mmHg]、动脉二氧化碳分压[PaCO2，（49.66±8.21）mmHg 比（45.37±8.12）mmHg]、内皮素（ET）-1[（53.45±15.11）pg／L 比（46.21±15.35） pg／L]水平，临床症状积分[（7.69±2.65）分比（5.41±2.49）分]明显降低；动脉血氧分压[PaO2，（76.14±8.65）mmHg]比（82.01±8.41）mmHg]、一氧化氮[NO，（63.94±12.85）μmol／L 比（70.94±13.95）μmol／L]水平，总有效率（63.83％比87.23％）显著升高，P ＜0.05或＜0.01。结论：硝酸甘油雾化吸入治疗肺源性心脏疾病，能够显著改善肺心病患者血管内皮功能，提高疗效。%Objective:To explore influence of nitroglycerin atomizing inhalation on vascular endothelial function in patients with pulmonary heart disease (PHD)onset.Methods:A total of 94 patients with PHD onset visiting to our hospital were randomly and equally divided into routine treatment group and atomizing inhalation group (inhalation group,received nitroglycerin atomizing inhalation based on routine treatment).Mean pulmonary arterial pressure (mPAP),blood gas analysis and score of clinical symptoms were observed.Results:Compared with routine treat-ment group,after treatment,there were significant reductions in mPAP [(27.97±3.42)mmHg vs.(23.21±3.34) mmHg],arterial partial pressure of carbon dioxide [PaCO2 ,(49.66±8.21)mmHg vs.(45.37±8.12)mmHg],en-dothelin-1 [ET-1,(53.45±15.11)pg/L vs.(46.21 ± 15.35)pg/L]level,and clinical symptom score [(7.69± 2.65)scores vs.(5.41±2.49)scores];and significant rise in arterial partial pressure of oxygen [PaO2 ,(76.14± 8.65)mmHg vs.(82.01±8.41)mmHg]and NO level [(63.94±12.85)μmol/L vs.(70.94±13.95)μmol/L],to-tal effective rate (63.83% vs.87.23%),P <0.05 or <0.01 in inhalation group.Conclusion:Nitroglycerin atomi-zing inhalation can significantly improve vascular endothelial function,raise therapeutic effect in treatment of pul-monary heart disease.