Troncy E, Francoeur M, Salazkin I, Yang F, Charbonneau M, Leclerc G, Vinay P, Blaise G
Anaesthesia Laboratory, Centre Hospitalier de l'Université de Montréal-Pavillon Notre-Dame, Québec, Canada.
Br J Anaesth. 1997 Nov;79(5):631-40. doi: 10.1093/bja/79.5.631.
We have compared the effects of inhaled nitric oxide (iNO) and i.v. nitroglycerin (ivGTN) on the haemodynamic response to phenylephrine-induced hypertension (PEHT) in anaesthetized pigs. PEHT did not change either pulmonary vascular resistance or gas exchange throughout all experiments. Both treatments lowered pulmonary arterial pressure to the same extent (-12.4% iNO; -13.7% ivGTN) and passively via an effect on left atrial pressure (-26.3% iNO; -31.4% ivGTN). Both treatments failed to reverse the decrease in renal blood flow (RBFc) induced by PEHT, but both increased urinary flow (UF) (+128% iNO; +148% ivGTN). IvGTN significantly increased plasma concentrations of nitrite and nitrate during (+22.7% arterial blood; +26.2% venous blood) and beyond the period of infusion (iNO: +6.4% and +4.9%, respectively). In four control pigs (no PEHT), iNO markedly increased RBFc (+109%), glomerular filtration rate (+72.5%) and UF (+68.7%). We conclude that iNO may have direct cardiac and renal effects, probably via intervention of NO carrier forms such as S-nitroso compounds.
我们比较了吸入一氧化氮（iNO）和静脉注射硝酸甘油（ivGTN）对麻醉猪去氧肾上腺素诱导的高血压（PEHT）血流动力学反应的影响。在所有实验中，PEHT均未改变肺血管阻力或气体交换。两种治疗方法均将肺动脉压降低至相同程度（iNO降低12.4%；ivGTN降低13.7%），且均通过影响左心房压力被动降低肺动脉压（iNO降低26.3%；ivGTN降低31.4%）。两种治疗方法均未能逆转PEHT诱导的肾血流量（RBFc）下降，但均增加了尿流量（UF）（iNO增加128%；ivGTN增加148%）。ivGTN在输注期间（动脉血增加22.7%；静脉血增加26.2%）及输注后显著增加血浆亚硝酸盐和硝酸盐浓度（iNO分别增加6.4%和4.9%）。在四只对照猪（未进行PEHT）中，iNO显著增加RBFc（增加109%）、肾小球滤过率（增加72.5%）和UF（增加68.7%）。我们得出结论，iNO可能具有直接的心脏和肾脏作用，可能是通过干预NO载体形式如S-亚硝基化合物来实现的。
