[Treatment with inhaled nitric oxide in patients with pulmonary embolism].

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2026-03-17 DOI:10.26442/00403660.2026.03.203544

I R Nurkaev, D G Soldatov

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引用次数: 0

Abstract

Background: Pulmonary embolism (PE) is accompanied by mechanical obstruction of pulmonary vascular bed, as well as pulmonary vasoconstriction, resulting as neurohumoral response to acute increase of pressure in pulmonary circulation system. It has been shown that vasospasm is making a significant contribution to pulmonary artery pressure (PAP) increase. Modern treatment of PE is mainly directed at restoring perfusion, while treatment of pulmonary vasoconstriction is overlooked. Nitrogen monoxide (NO) is endothelial mediator that has vasorelaxing and moderate antiplatelet properties that allow correcting the severity of pulmonary vasoconstriction.

Aim: To assess efficacy and safety of inhaled NO therapy in complex treatment of PE.

Materials and methods: The study involved patients with moderate-low-risk PE (n = 65) who were randomized into two groups: experimental (n = 30, 27 men, 3 women, mean age 53,1 ± 16,8 years) and control group (n = 35, 21 men, 14 women, mean age 56,8 ± 14,1 years old). Patients in experimental group received inhaled NO therapy with standard anticoagulant therapy, while control group received only anticoagulants.

Results: On the 10th day of the study, experimental group showed significantly more pronounced decrease of systolic PAP (sPAP) and right heart sizes compared with control group. There was also statistically significant positive dynamics of vital signs (respiratory rate, heart rate, blood pressure) and dyspnea (mMRC), arterial oxygen partial pressure, nitrosative status (exhaled NO and saliva nitrite), NT-proBNP compared with control group.

Conclusion: Inhaled NO therapy in complex therapy of PE demonstrated safety and efficacy in relation to clinical, functional and laboratory parameters.

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[肺栓塞患者吸入一氧化氮治疗]。

背景：肺栓塞（Pulmonary embolism， PE）伴随着肺血管床的机械性阻塞和肺血管收缩，导致肺循环系统急性压力升高的神经体液反应。研究表明，血管痉挛是肺动脉压（PAP）升高的重要原因。现代PE的治疗以恢复灌注为主，忽视了肺血管收缩的治疗。一氧化氮（NO）是内皮介质，具有血管松弛和中度抗血小板特性，可纠正肺血管收缩的严重程度。目的：评价吸入一氧化氮治疗肺心病的疗效和安全性。材料与方法：本研究纳入65例中低危PE患者，随机分为实验组（男性30 27例，女性3例，平均年龄53,1±16,8岁）和对照组（男性35例，21例，女性14例，平均年龄56,8±14,1岁）。实验组患者在标准抗凝治疗的基础上给予吸入NO治疗，对照组患者仅给予抗凝治疗。结果：实验第10天，实验组大鼠收缩期PAP （sPAP）和右心大小下降明显高于对照组。与对照组相比，生命体征（呼吸频率、心率、血压）、呼吸困难（mMRC）、动脉氧分压、亚硝化状态（呼出NO和唾液亚硝酸盐）、NT-proBNP均有统计学意义的正动态变化。结论：吸入NO疗法在PE综合治疗中具有临床、功能和实验室参数方面的安全性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.