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目的:研究高原肺水肿的发生与血浆一氧化氮( N O) 、一氧化氮合成酶( N O S) 和心钠素( A N P) 的关系。方法:在海拔3 700m 对11 例高原肺水肿患者在治疗前和治愈后分别检测其血浆 N O、 N O S和 A N P含量,并与初入海拔3 700 m 的10 名健康青年作对照。结果:高原肺水肿组 N O 治愈后较治疗前增高非常显著( P< 0 .01) , A N P 降低非常显著( P< 0 .01) , N O S 无显著性差异( P> 0 .05) ;治愈后 N O 和 A N P显著低于健康青年组( P< 0 .05) ,治疗前较健康青年 N O、 N O S降低非常显著( P< 0 .01) , A N P 增高显著( P< 0 .05) 。治疗前血浆 N O 含量与 N O S 活性呈高度正相关(r= 0 .8646 , P< 0 .01) 。结论:血浆 N O、 N O S和 A N P均参与了高原肺水肿的病理生理过程,血浆 A N P含量升高可能是机体的一种保护性代偿机制。
Objective: To study the relationship between the occurrence of altitude pulmonary edema and plasma levels of nitric oxide (NO), nitric oxide synthase (N O S) and atrial natriuretic peptide (A N P). Methods: Eleven patients with pulmonary edema at altitude of 3 700 m were examined for plasma N O, N O S and A N P before and after treatment, and compared with 10 healthy young people . Results: The N0 O in high altitude pulmonary edema group was significantly higher than that before treatment (P <0.01), and the A N P decrease was significant (P <0.01). There was no significant difference in N O S between the two groups (P> 0.05). (P0.05) .N O and N O S decreased significantly (P <0.01) before treatment compared with that of healthy youth Increase significantly (P <0 .05). The plasma N O level before treatment was positively correlated with NOS activity (r = 0.8664, P <0.01). Conclusion: Plasma N O, N O S and A N P are both involved in the pathophysiological process of high altitude pulmonary edema. Increased plasma N-P may be a protective compensatory mechanism.