Beghetti Maurice, Spahr-Schopfer Isabelle, Mensi Nouri, Morel Denis R, Rimensberger Peter C
Cardiology Unit, University of Geneva Hospital, Geneva, Switzerland.
Med Sci Monit. 2003 Jun;9(6):BR193-8.
In order to compare the effects of inhaled nitric oxide (NO) and magnesium (Mg) and their potential synergism on hemodynamics in pulmonary hypertension, we compared the effect of NO and Mg alone and in combination. The fact that simultaneous administration selectively increases pulmonary vascular relaxation would suggest that their association would allow for a decrease in the NO concentration required for optimal pulmonary vasodilation, thus lowering the risk of side effects.
MATERIAL/METHODS: We compared the effects of 20 ppm inhaled NO, 25 mg/kg Mg, and combined therapy in a pig model of hypoxic pulmonary hypertension. Twelve animals were randomly assigned to one of 3 treatment groups: control (group 1); Mg+NO group, receiving Mg followed by NO 15 min later (group 2); NO+Mg group, receiving NO followed by Mg 15 min later (group 3). The cardiac index, pulmonary and systemic pressures, pulmonary and systemic resistance, and the pulmonary to systemic resistance ratio (PVR/SVR) were recorded at baseline, on hypoxia and 15 minutes after each drug alone and in combination.
PVR/SVR decreased with NO alone (0.32+/-0.07 to 0.18+/-0.04; p<0.05) but not with Mg alone. When NO was added to Mg, PVR/SVR decreased significantly (0.31+/-0.06 to 0.16+/-0.02; p<0.05) but not when Mg was added to NO.
Inhaled NO is a selective pulmonary vasodilator in a pig model of hypoxic pulmonary hypertension. The simultaneous administration of intravenous Mg does not enhance the selective pulmonary vasodilation induced by NO inhalation.
为比较吸入一氧化氮（NO）和镁（Mg）及其潜在协同作用对肺动脉高压血流动力学的影响，我们比较了单独使用NO和Mg以及联合使用时的效果。同时给药能选择性增加肺血管舒张这一事实表明，二者联合使用可降低实现最佳肺血管舒张所需的NO浓度，从而降低副作用风险。
材料/方法：我们在低氧性肺动脉高压猪模型中比较了20 ppm吸入NO、25 mg/kg Mg及联合治疗的效果。12只动物被随机分为3个治疗组之一：对照组（第1组）；Mg + NO组，先给予Mg，15分钟后给予NO（第2组）；NO + Mg组，先给予NO，15分钟后给予Mg（第3组）。在基线、低氧时以及单独和联合给予每种药物后15分钟记录心脏指数、肺和体循环压力、肺和体循环阻力以及肺循环与体循环阻力比值（PVR/SVR）。
单独使用NO时PVR/SVR降低（从0.32±0.07降至0.18±0.04；p<0.05），但单独使用Mg时未降低。当在Mg基础上加用NO时，PVR/SVR显著降低（从0.31±0.06降至0.16±0.02；p<0.05），但在NO基础上加用Mg时未降低。
在低氧性肺动脉高压猪模型中，吸入NO是一种选择性肺血管舒张剂。静脉注射Mg与吸入NO同时给药并不能增强吸入NO诱导的选择性肺血管舒张作用。
