ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2023, Vol. 15 ›› Issue (3): 195-198.

• 小儿心血管疾病康复专栏 • 上一篇    下一篇

吸入一氧化氮对新生儿持续性肺动脉高压患儿氧供状态、左心功能及血小板聚集功能的影响

  

  • 出版日期:2023-06-25 上线日期:2023-11-22

Effects of inhaled nitric oxide on oxygen supply status,left heart function and platelet aggregation in neonates with persistent pulmonary hypertension

  • Published:2023-06-25 Online:2023-11-22

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摘要： 目的 探索吸入一氧化氮(NO)对新生儿持续性肺动脉高压(PPHN)患儿氧供状态、左心功能及血小板聚集功能的影响。方法 选取2019年4月至2022年3月我院收治的PPHN患儿80例作为研究对象，随机分为常规组和联合组各40例。常规组予高频振荡通气，联合组给予联合吸入NO,对比两组患儿氧供状态、血小板聚集功能、左心功能水平及结局。结果 协方差分析结果显示，联合组干预72 h末血氧饱和度(SaO2)、血氧分压(PaO2)水平高于常规组；氧合指数低于常规组，差异均有统计学意义(P<0.05)。联合组干预72 h末血小板聚集率、P-选择素、血小板膜糖蛋白(GPⅡb/Ⅲa)水平低于常规组，差异均有统计学意义(P<0.05)。两组干预72 h末左心室二尖瓣环舒张早期峰值速度(em)水平经比较差异无统计学意义(P>0.05);联合组干预72 h末左心室收缩期峰值速度(sm)、左心室输出量高于常规组，Tei指数低于常规组，差异均有统计学意义(P<0.05)。经Fisher确切概率法检验，联合组病死率为0.00%(0/40),常规组为7.50%(3/40),经比较差异无统计学意义(P=0.241)。结论 吸入NO可调节新生儿PPHN患儿左心功能，改善氧供状态，调节血小板聚集功能，提高生存率。 

关键词: 持续性肺动脉高压, 吸入一氧化氮, 左心功能, 新生儿

Abstract: ObjectiveTo explore the effects of inhaled nitric oxide (NO) on oxygen supply status,left heart function and platelet aggregation in neonates with persistent pulmonary hypertension (PPHN).MethodsA total of 80 children with PPHN admitted to our hospital from April 2019 to March 2022 were selected as the study subjects and randomly divided into the conventional group and the combined group with 40 cases in each group.The conventional group was given high-frequency shock ventilation,and the combined group was given combined inhalation NO.The oxygen supply status,platelet aggregation function,left heart function and outcome of the two groups were compared.ResultsThe results of covariance analysis showed that the levels of blood oxygen saturation (SaO2) and blood oxygen partial pressure (PaO2) at the end of 72h of intervention in the combined group were higher than those in the conventional group;the oxygenation index was lower than that of the conventional group;the difference was statistically significant (P<0.05).The platelet aggregation rate,P-selectin and platelet membrane glycoprotein (GPⅡb/Ⅲa) levels in the combined group at the end of 72h after intervention were lower than those in the conventional group,and the differences were statistically significant (all P<0.05).There was no significant difference in the early peak diastolic velocity (em) of left ventricular mitral ring between the two groups at the end of 72h after intervention (P>0.05).Left ventricular systolic peak velocity (sm) and left ventricular output in combined group were higher than those in conventional group at the end of 72h after intervention,and Tei index was lower than that in conventional group,the differences being of statistical significance (P<0.05).By Fisher′s exact probability test,the fatality rate was 0.00% (0/40) in the combined group and 7.50% (3/40) in the conventional group,the differences being of no statistical significance (P=0.241).ConclusionInhalation of NO can regulate the left heart function,improve the oxygen supply status,regulate the platelet aggregation function and improve the survival rate of PPHN children.

Key words:

Persistent pulmonary hypertension, Inhalation of nitric oxide, Left heart function, Newborn