基礎肺血管抵抗と酸化窒素反応は,フォンタン型の手術後の遅い時期に発生する
S Khambadkone1, J Li, M R de Leval
1Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK. s.khambadkone@ich.ucl.ac.uk
Circulation
|June 25, 2003
まとめ
肺血管抵抗 (PVR) は,フォンタン患者の酸化窒素 (NO) により低下し,肺血流の変化による内皮機能不全を示唆しています. NO強化療法に関するさらなる研究が必要である.
科学分野:
- 心臓病学 心臓病学
- ペディアトリック・カルディオロジー
- 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧 肺動脈高血圧
背景:
- 脈動性肺血流は,酸化窒素 (NO) の放出と肺血管抵抗 (PVR) の低下に不可欠です.
- フォンタン型の操作は正常な脈動性流れを妨害しますが,PVRとNO応答性に対する遅い影響は不明です.
研究 の 目的:
- ファンタン型手術を受けた患者の基礎PVRと,外因的なNOに対する反応性を評価する.
- これらの患者の潜在的な肺内皮機能不全を調査するために.
主な方法:
- インデックスPVR (PVRI) は,フィック原理と呼吸器質量スペクトロメトリを用いて測定された.
- 15人の患者 (平均年齢12歳) はNOを吸入した (10分間に20ppm).
- 患者はフォントン手術後の平均9年後に評価されました.
主要な成果:
- 基礎PVRIは2.11+/-0.79 WU*m2で,NOを吸入した後に1.61+/-0.48 WU*m2に大幅に減少した (P=0.016).
- 非脈動性フローの患者は,PVRIの減少をNO.の後に2.18+/-0.34から1.82+/-0.55 WU*m2に示した.
結論:
- 外因的なNOは,フォンタン型手術の後の遅い時期にPVRを著しく低下させる.
- これらの発見は,肺内皮機能不全を示唆し,潜在的に変化した非脈動性流動特性に関連しています.
- 肺内皮 NO の放出を促進する治療戦略は,これらの患者に有益である可能性があります.
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