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目的 :探讨左旋精氨酸 (L -Arg)对高原肺水肿 (HAPE)治疗前后血气的影响 ;方法 :在海拔 370 0m采用氧气驱动雾化吸入L -Arg治疗HAPE患者 9例 ,在治疗前、治疗后即刻及临床治愈后分别检测动脉血 pH值、二氧化碳分压 (PCO2 )、氧分压 (PO2 )、肺泡、动脉氧分压差 (AaDO2 )、血氧饱和度 (SaO2 ) ,并与常规治疗作比较 ;结果 :L -Arg组和对照组治疗前较治疗后即刻和临床治愈后 pH值、AaDO2 增高 ,PCO2 、PO2 、SaO2 降低 (P<0 .0 1 )。治疗后即刻较临床治愈后PO2 、SaO2 增高 ,PCO2 、AaDO2 降低 (P <0 .0 1 ) ,pH值无统计学差异 (P >0 .0 5) ;L -Arg组与对照组比较 ,治疗前和治愈后各指标均无统计学差异 (P >0 .0 5) ;治疗即刻pH值、AaDO2 增高 ,PCO2 、PO2 、SaO2 降低 (P <0 .0 1或P <0 .0 5) ;结论 :L -Arg可明显改善HAPE患者血气指标 ,对HAPE治疗效果显著 ,且简便易于推广应用。
Objective: To investigate the effect of L-arginine (L-Arg) on blood gas before and after treatment of high altitude pulmonary edema (HAPE) .Methods: 9 cases of HAPE were treated with inhalation of L- The arterial blood pH, carbon dioxide partial pressure (PCO2), oxygen partial pressure (PO2), alveolar, arterial oxygen pressure difference (AaDO2) and blood oxygen saturation (SaO2) were detected immediately and after clinical cure, The levels of AaDO2, PCO2, PO2 and SaO2 in the L-Arg group and the control group were significantly lower than those before the treatment (P <0.01). After treatment, the PO2 and SaO2 increased, the PCO2 and AaDO2 decreased (P <0.01), but there was no significant difference between the two groups (P> 0.05), the L-Arg group and the control group There was no significant difference in each index before and after treatment (P> 0.05). At the instant of treatment, the AaDO2 increased, the PCO2, PO2 and SaO2 decreased (P <0.01 or P <0.05); Conclusion: L-Arg can significantly improve blood gas index in patients with HAPE, the treatment of HAPE effect is significant, and easy to promote the use of simple.