Spence C R, Thompson B T, Janssens S P, Steigman D M, Hales C A
Massachusetts General Hospital (Pulmonary/Critical Care Unit), Harvard Medical School, Boston, Massachusetts 02114.
Am Rev Respir Dis. 1993 Jul;148(1):241-4. doi: 10.1164/ajrccm/148.1.241.
Chronic hypoxia produces pulmonary artery hypertension through vasoconstriction and structural remodeling of the pulmonary vascular bed. The present study was designed to test the effect of heparin administered via aerosol on the development of hypoxic pulmonary hypertension. Anesthetized, intubated, and mechanically ventilated guinea pigs received an aerosol of either 2 ml normal saline (hypoxic control, HC) or 4,500 units of heparin diluted in 2 ml normal saline via an ultrasonic nebulizer (hypoxic heparin, HH). After 24 h of recovery, the animals were placed in a hypoxic chamber (10% O2) for 10 days. Animals kept in room air served as normoxic controls (NC). Hypoxia increased mean pulmonary artery pressure from 11 +/- 1 (SEM) mm Hg in NC to 24 +/- 1 mm Hg in HC (p < 0.05). Pulmonary artery pressure was significantly lower in HH-treated animals (20 +/- 1 mm Hg, p < 0.05 versus HC) as was the total pulmonary vascular resistance (0.15 +/- 0.01 in HH versus 0.20 +/- 0.01 mm Hg/ml/min in HC, p < 0.05). There was no difference in cardiac output (146 +/- 12 in HH versus 126 +/- 7 ml/min in HC), hematocrit (57 +/- 2 in HH versus 56 +/- 2% in HC), partial thromboplastin time (30 +/- 2 in HH versus 32 +/- 3 s in HC), prothrombin time (46 +/- 1 in HH versus 48 +/- 4 s in HC) or room air arterial blood gas values after 10 days of hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)
慢性缺氧通过肺血管床的血管收缩和结构重塑导致肺动脉高压。本研究旨在测试经气雾剂给予肝素对缺氧性肺动脉高压发展的影响。将麻醉、插管并机械通气的豚鼠通过超声雾化器给予2 ml生理盐水气雾剂(缺氧对照组,HC)或用2 ml生理盐水稀释的4500单位肝素气雾剂(缺氧肝素组,HH)。恢复24小时后,将动物置于缺氧舱(10%氧气)中10天。置于室内空气中的动物作为常氧对照组(NC)。缺氧使平均肺动脉压从NC组的11±1(SEM)mmHg升高至HC组的24±1 mmHg(p<0.05)。HH治疗组动物的肺动脉压显著降低(20±1 mmHg,与HC组相比p<0.05),总肺血管阻力也降低(HH组为0.15±0.01,HC组为0.20±0.01 mmHg/ml/min,p<0.05)。心输出量(HH组为146±12,HC组为126±7 ml/min)、血细胞比容(HH组为57±2,HC组为56±2%)、部分凝血活酶时间(HH组为30±2,HC组为32±3 s)、凝血酶原时间(HH组为46±1,HC组为48±4 s)或缺氧10天后的室内空气动脉血气值均无差异。(摘要截断于250字)