Wang Ling, Zhu Du Ming, Su Xiao, Bai Chun Xue, Ware Lorraine B, Matthay Michael A
Research Institute of Respiratory Diseases and Department of Surgical Intensive Care Unit, Zhongshan Hospital, Fudan University, Shanghai, China.
Exp Lung Res. 2004 Jan-Feb;30(1):31-42. doi: 10.1080/01902140490252821.
The objective of this study was to evaluate the cardiopulmonary effects of a dual-endothelin (ET) receptor antagonist, Tezosentan, on oleic acid (OA)-induced acute lung injury with pulmonary arterial hypertension in dogs. Twelve pentobarbital-anesthetized dogs with intravenous OA-induced acute lung injury (ALI) were divided into 2 groups. The control group (n=6) received saline treatment, whereas the treatment group (n=6) received the ET receptor antagonist, Tezosentan (1 mg/kg intravenous [i.v.]+1 mg/kg/h i.v. infusion). Cardiopulmonary parameters were monitored continuously for 1 hour. OA administration resulted in a significant increase in mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR) and a decrease in mean systemic arterial pressure (MSAP), systemic vascular resistance (SVR), and cardiac output (CO) in all dogs. Tezosentan treatment markedly attenuated the pulmonary hypertension, with a 32% decrease in MPAP (from 23 +/- 2 mm Hg to 15 +/- 2 mm Hg; P<.01) and a 22% decrease in PVR (from 860 +/- 105 dyn.s.cm(-5) to 670 +/- 96 dyn.s.cm(-5); P<.01) at the end of study. MSAP and SVR were unchanged after Tezosentan treatment, and there was an increase in cardiac output and a decline in peak inspiratory pressure (PIP) in the Tezosentan group compared with the control group. These results indicate that the dual-ET receptor antagonist, Tezosentan, can attenuate the pulmonary hypertension induced by OA. Thus, dual-ET receptor antagonists such as Tezosentan may be useful in the management of acute pulmonary arterial hypertension, complicating the course of OA-induced lung injury.
本研究的目的是评估双重内皮素(ET)受体拮抗剂替唑生坦对油酸(OA)诱导的犬急性肺损伤伴肺动脉高压的心肺效应。将12只戊巴比妥麻醉的犬经静脉注射OA诱导急性肺损伤(ALI),分为2组。对照组(n = 6)接受生理盐水治疗,而治疗组(n = 6)接受ET受体拮抗剂替唑生坦(静脉注射1 mg/kg + 静脉输注1 mg/kg/h)。连续监测心肺参数1小时。所有犬静脉注射OA后,平均肺动脉压(MPAP)和肺血管阻力(PVR)显著升高,平均体动脉压(MSAP)、体循环血管阻力(SVR)和心输出量(CO)降低。替唑生坦治疗显著减轻了肺动脉高压,研究结束时MPAP降低了32%(从(23±2)mmHg降至(15±2)mmHg;P<0.01),PVR降低了22%(从(860±105)dyn·s·cm⁻⁵降至(670±96)dyn·s·cm⁻⁵;P<0.01)。替唑生坦治疗后MSAP和SVR未改变,与对照组相比,替唑生坦组心输出量增加,吸气峰压(PIP)下降。这些结果表明,双重ET受体拮抗剂替唑生坦可减轻OA诱导的肺动脉高压。因此,像替唑生坦这样的双重ET受体拮抗剂可能有助于治疗急性肺动脉高压,这是OA诱导的肺损伤过程中的并发症。