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目的 :探讨一氧化氮 (NO)和低密度气体—氦氧混合气 (Heliox)对健康成人气道激发后的作用。方法 :选择健康成年非吸烟男性 12名作为受试者 ,吸入乙酰甲胆碱 (Mch) ,激发气道。受试者坐位 ,带鼻罩 ,通过呼吸机自主呼吸。实验分三阶段进行 ,即气道激发后吸入空气 ;激发后吸入氦氧混合气和同时吸入一氧化氮及氦氧混合气。检测用力肺活量 (FVC)、第一秒用力呼气量 (FEV1)和用力呼气中期流速 (MMF)。结果 :气道激发后 ,三组的FEV1均显著下降 ,与基础值比较差异有显著意义 (P <0 0 5 )。在吸入氦氧混合气期间FEV1和MMF值高于吸入空气组 ,差异有显著意义。吸入Heliox的同时加入NO能使FEV1进一步提高 ,但不能进一步改善MMF。与空气组相比 ,吸入Heliox组及吸入Heliox时加入NO ,FVC有增加趋势。结论 :本研究结果提示 ,高浓度的NO虽然能对抗乙酰甲胆碱引起的气道收缩 ,但作用较弱。而氦氧混合气对大小气道均有作用 ,其改善通气功能的作用明显强于NO ,临床应用前景广阔。
Objective: To investigate the effect of nitric oxide (NO) and low-density gas-Heliox on airway in healthy adults. Methods: Twelve healthy adult non-smokers were selected as subjects and inhaled methacholine (Mch) to stimulate the airway. Subjects sitting, with nasal mask, breathe through the breathing machine. The experiment was divided into three stages, namely the inhalation of air after the airway was excited; inspired inhalation of helium-oxygen mixture and simultaneous inhalation of nitric oxide and helium-oxygen mixture. FVC, FEV1, and forced expiratory flow (MMF) were measured. Results: After airway stimulation, FEV1 in all three groups decreased significantly compared with the baseline (P <0.05). The difference was significant when the FEV1 and MMF values were higher during inhalation of helium-and-oxygen mixture than the inhaled air group. Inhalation of Heliox while adding NO increased FEV1 further, but did not improve MMF further. Compared with the air group, inhaled Heliox group and inhaled Heliox when adding NO, FVC has an increasing trend. Conclusion: The results of this study suggest that high concentrations of NO, although able to counteract methacholine-induced airway contractions, are less effective. The helium-oxygen mixture has an effect on the size of the airway, its role in improving ventilation was significantly stronger than the NO, a broad clinical application.