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探讨吸入低浓度一氧化氮 (NO)治疗高原肺水肿甲襞微循环的变化与机理 ;方法 :12例高原肺水肿患者 ,在常规治疗基础上吸入浓度为 10× 10 - 6 NO 30分钟 ,用WX -6型微循环显微仪观察高原肺水肿NO治疗前、治疗 45分钟和治愈后甲襞微循环变化 ;结果 :治疗前与治疗 45分钟及治愈后比较 ,甲襞毛细血管管袢输入枝缩小 ,输出枝管经和袢顶增宽 ,A/V比例失调 ,血流变慢呈粒流和粒缓流 (占 83% ) ,伴RBC聚集和袢渗出 (占 6 7% ) ,毛细血管形态 ,血液流态和袢周状态加权积分值和总积分值增大 ,统计学处P <0 .0 5～P <0 .0 0 1)。治疗 45分钟与治愈后比较 ,管袢数、输入枝管径和管形态加权积分值无明显变化 (P <0 .0 5 ) ,其它各项变化显著 (P <0 .0 1～P <0 .0 0 1)。Hb显著高于治疗 45分和治愈后 (P <0 .0 0 1) ,治愈后又高于治疗 45分时 (P <0 .0 5 )。结论 :吸入低浓变NO对急性缺氧性肺动脉高压有非常显著的降压作用 ,对救治高原肺水肿起重要作用 ,通过迅速纠正低血氧症而改变甲襞微循环。
To investigate the changes and mechanism of inhalation of low concentration nitric oxide (NO) in the treatment of high altitude pulmonary edema caused by nailfold microcirculation.Methods: In 12 patients with altitude pulmonary edema, inhaled at a concentration of 10 × 10 - 6 NO for 30 minutes WX-6 microcirculation microscope observation of high altitude pulmonary edema before treatment, 45 minutes after treatment and healing of nailfold microcirculation changes; Results: Before treatment and treatment of 45 minutes and after treatment, Narrowed, the output of the branch and the top of the ridge widened, A / V imbalance, slowed blood flow was granular and granular slow flow (83%), with RBC aggregation and leakage (accounting for 67%), capillary Vascular morphology, blood flow and periweight state weighted integral value and the total value increased, the statistical office P <0. 05 ~ P <0. After treatment for 45 minutes, there were no significant changes (P <0. 05) in the number of tube loops, the diameter of the input branch and the shape of the tube. The other changes were significant (P <0.01 ~ P <0 .0 0 1). Hb was significantly higher than 45 minutes after treatment and after treatment (P <0.01), and after treatment was higher than 45 minutes (P <0.05). CONCLUSION: Inhalation of low concentration of nitric oxide has a very significant antihypertensive effect on acute hypoxic pulmonary hypertension and plays an important role in the treatment of high altitude pulmonary edema. It can change the microcirculation of nailfolds by rapidly correcting hypoxemia.