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目的 :研究静脉滴注左旋精氨酸 (L -arg)对高原肺水肿的治疗价值 ;方法 :75例高原肺水肿患者随机分为 3组 ,硝苯吡啶组 ( 2 4例 ) ,口服硝苯吡啶、吸氧、静脉注射速尿、氨茶碱和地塞米松治疗 ;一氧化氮 (NO)组 ( 2 5例 ) ,在硝苯吡啶治疗的基础上一次性吸入 1 0 ppmNO3 0分钟 ;精氨酸组 ( 2 6例 ) ,在硝苯吡啶治疗的基础上 ,以L -arg 2 0 g加入 5%葡萄糖溶液 50 0ml,一次性 4h静脉滴注 ,比较各组病例肺部罗音、X线胸片阴影消失时间及病程长短 ;结果 :精氨酸组肺部湿性罗音消失时间较NO组长 ,较硝苯吡啶组短 ,差异显著 (P <0 .0 5) ;精氨酸组肺部X线阴影消失时间及病程时间较NO组长 ,较硝苯吡啶组短 ,差异非常显著 (P <0 .0 1或P <0 .0 0 1 ) ;结论 :静脉滴注L -arg是治疗高原肺水肿比较有效的方法
Objective: To study the value of intravenous infusion of L-arginine (L-arginine) on the treatment of high altitude pulmonary edema.Methods: Seventy-five patients with high altitude pulmonary edema were randomly divided into three groups: nifedipine group (n = 24) Pyridine, oxygen, intravenous furosemide, aminophylline and dexamethasone; NO group (25 cases), nifedipine treatment based on a single inhalation of 10 ppmNO3 0 minutes; fine On the basis of the treatment with nifedipine, 500 ml of 5% dextrose solution was added into L-arg 2 0 g group and 4-hour intravenous instillation. The pulmonary rales, X The disappearance time of the linear chest radiograph and duration of the course of the disease were measured. The results showed that the disappearance time of wet rales in the arginine group was longer than that in the NO group and shorter than that in the nifedipine group (P <0.05) Lung X-ray shadow disappear time and course of disease longer than the NO group, compared with nifedipine group, the difference was significant (P <0.01 or P <0.01); Conclusion: intravenous infusion of L-arg Is the treatment of high altitude pulmonary edema more effective way