Dupuy P M, Shore S A, Drazen J M, Frostell C, Hill W A, Zapol W M
Department of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
J Clin Invest. 1992 Aug;90(2):421-8. doi: 10.1172/JCI115877.
The effects of inhaling nitric oxide (NO) on airway mechanics were studied in anesthetized and mechanically ventilated guinea pigs. In animals without induced bronchoconstriction, breathing 300 ppm NO decreased baseline pulmonary resistance (RL) from 0.138 +/- 0.004 (mean +/- SE) to 0.125 +/- 0.002 cmH2O/ml.s (P less than 0.05). When an intravenous infusion of methacholine (3.5-12 micrograms/kg.min) was used to increase RL from 0.143 +/- 0.008 to 0.474 +/- 0.041 cmH2O/ml.s (P less than 0.05), inhalation of 5-300 ppm NO-containing gas mixtures produced a dose-related, rapid, consistent, and reversible reduction of RL and an increase of dynamic lung compliance. The onset of bronchodilation was rapid, beginning within 30 s after commencing inhalation. An inhaled NO concentration of 15.0 +/- 2.1 ppm was required to reduce RL by 50% of the induced bronchoconstriction. Inhalation of 100 ppm NO for 1 h did not produce tolerance to its bronchodilator effect nor did it induce substantial methemoglobinemia (less than 2%). The bronchodilating effects of NO were additive with the effects of inhaled terbutaline, irrespective of the sequence of NO and terbutaline administration. Inhaling aerosol generated from S-nitroso-N-acetylpenicillamine also induced a rapid and profound decrease of RL from 0.453 +/- 0.022 to 0.287 +/- 0.022 cmH2O/ml.s, which lasted for over 15 min in guinea pigs broncho-constricted with methacholine. Our results indicate that low levels of inhaled gaseous NO, or an aerosolized NO-releasing compound are potent bronchodilators in guinea pigs.
在麻醉并机械通气的豚鼠身上研究了吸入一氧化氮(NO)对气道力学的影响。在未诱发支气管收缩的动物中,吸入300 ppm的NO可使基线肺阻力(RL)从0.138±0.004(平均值±标准误)降至0.125±0.002 cmH₂O/ml·s(P<0.05)。当静脉输注乙酰甲胆碱(3.5 - 12微克/千克·分钟)使RL从0.143±0.008升高至0.474±0.041 cmH₂O/ml·s(P<0.05)时,吸入含5 - 300 ppm NO的气体混合物可使RL产生剂量相关、快速、持续且可逆的降低,并使动态肺顺应性增加。支气管扩张起效迅速,吸入开始后30秒内即可出现。将RL降低至诱发支气管收缩时的50%需要吸入浓度为15.0±2.1 ppm的NO。吸入100 ppm的NO 1小时不会产生对其支气管扩张作用的耐受性,也不会导致大量高铁血红蛋白血症(<2%)。无论NO和特布他林的给药顺序如何,NO的支气管扩张作用与吸入特布他林的作用具有相加性。吸入由S - 亚硝基 - N - 乙酰青霉胺产生的气雾剂也可使RL从0.453±0.022迅速大幅降至0.287±0.022 cmH₂O/ml·s,在因乙酰甲胆碱诱发支气管收缩的豚鼠中持续超过15分钟。我们的结果表明,低水平吸入气态NO或雾化的NO释放化合物在豚鼠中是强效支气管扩张剂。