Fineman J R, Zwass M S
Department of Pediatrics, University of California, San Francisco, USA.
Acta Paediatr Jpn. 1995 Aug;37(4):425-30. doi: 10.1111/j.1442-200x.1995.tb03350.x.
Increasing evidence suggests that the pulmonary vascular endothelium is an important mediator of resting pulmonary vascular tone through the synthesis and release of a variety of vasoactive substances including nitric oxide (NO). In addition, pulmonary endothelial dysfunction (such as impairment of NO synthesis) is present in lung injury and may contribute to the pathophysiology of pulmonary hypertensive disorders. Recently, exogenously administered NO gas has been utilized to treat infants with persistent pulmonary hypertension of the newborn (PPHN). These preliminary studies suggest that inhaled NO is a promising new therapy for the treatment of infants with PPHN. Controlled clinical trials must now be performed to determine if the use of inhaled NO improves the long-term outcome of patients with PPHN. Long-term exposure must be monitored closely for potential toxicity which includes methemoglobinemia and lung injury secondary to peroxynitrite and nitrogen dioxide production.
越来越多的证据表明，肺血管内皮通过合成和释放包括一氧化氮（NO）在内的多种血管活性物质，是静息肺血管张力的重要调节因子。此外，肺损伤时存在肺内皮功能障碍（如NO合成受损），这可能导致肺动脉高压性疾病的病理生理过程。最近，外源性给予的NO气体已被用于治疗新生儿持续性肺动脉高压（PPHN）患儿。这些初步研究表明，吸入NO是治疗PPHN患儿的一种有前景的新疗法。现在必须进行对照临床试验，以确定吸入NO是否能改善PPHN患者的长期预后。必须密切监测长期接触NO的潜在毒性，包括高铁血红蛋白血症以及因过氧亚硝酸盐和二氧化氮生成导致的肺损伤。
