Objective: This study was designed to evaluate myocardial injury in patients with or without
pulmonary hypertension (PH) during intracardiac surgery in Lhasa. Methods: 24 patients with
congenital heart disease undergoing cardiac operations were enrolled into the study. 12 patients
with pulmonary artery pressure over 30mmHg were in the PH group and 12 patients with
pulmonary artery pressure less than 20mmHg in the control group (NP). Perioperative plasma
cTnT, ET-1 were measured dynamically. Results: Plasma cTnT and ET-1 during and after CPB in
patients with pulmonary hypertension were higher than those in patients without pulmonary
hypertension. Conclusion: Intracardiac procedures performed at high altitude caused severe
myocardial damage in patients with pulmonary hypertension. The results suggested that the
higher level of plasma ET-1 during CPB might be one of these factors, which could induce such
injuries.
207.
SYSTEMIC GLUCOCORTICOIDS IN SEVERE EXACERBATIONS OF ELDERLY
PATIENTS WITH CHRONIC COR PULMONALE IN HIGH ALTITUDE . Yang Sheng-Yu
1
,
Feng En-Zhi
2
, Qi Yu-Shu
2
, Zhang Ying
2
, Gao Ling
2
, Dong Hong-Mei
2
. of Respiratory Disease,
the
4
th Hospital of PLA, Xining, China
1
, Department of Respiratory Disease, the 4th Hospital of
PLA, Xining, China
2
.
Objective_To compare the efficacy of 3-day and 10-day courses of glucocorticoids in severe
exacerbations of elderly patients with chronic cor pulmonale in high altitude areas (HACCP).
Methods 78 patients with severe excerbations of HACCP were assigned randomly to two groups.
Group (39 cases) received dexamethasone,0.2 mg/kg IV q12h for 3 days, followed by saline IV
b.i.d. over the subsequent 3 days and once daily over the final 4 days. Group (39 cases) received
dexamethasone, 0.2 mg/kg IV q12h for the first 3 days, followed by 0.1 mg/kg IV b.i.d. for 3
days and 0.1 mg/kg IV once daily for the final 4 days. On days 0, 3, 10 and after therapy, lung
function, arterial blood gas, dyspnea scores, cough and sputum were documented. Results At day
3 after therapy, FEV1% predicted, PaO2 and PaCO2 in group were 35.9±7.6%, 44.4±5.8
mmHg_ and 46.1±5.8 mmHg, respectively. Those in group _ were 34.8±7.3%, 45.0±5.7mmHg
and 46.9±5.0mmHg, respectively. At day 10, these same values in group were 36.7±7.6%,
45.6±6.1mmHg and 44.8±5.2mmHg, respectively. Those in group were 42.0±7.1 %, 49.7±6.3
mmHg and 41.7±4.2 mmHg, respectively. Parameters in both groups differed markedly compared
with those before therapy (all P<0.01). Symptom score, FEV1%, FEV1/FVC, PaO2 and PaCO2
in two groups were improved significantly at day 3. At day 10, the parameters in group II, but not
in group I, continued to improve. After 6 months, symptom scores had no significant difference
between two groups (P0.05). Conclusion: The use of short-term systemic glucocorticoids to treat
severe exacerbations of elderly patients with HACCP is safe and effective. A 10-day course of
glucocorticoid treatment is more effective than a 3-day course in improving pulmonary
ventilatory function, blood gases and symptoms scores.
208.
VENTILATORY RESPONSE TO HYPOXIA AND HYEROXIA IN NATIVE HIGHLANDERS
AT HIGH ALTITUDE. Yang Sheng-Yue
1
, Feng En-Zhi
1
, Ma Zi-Qi
1
, 4th Hospital of PLA,
Xining, China
1
.
Objective To study the ventilatory response to hypoxia and hyperoxia in new migrators,
resident migrators and native highlanders at high altitude. Methods Ventilatory responses to
breathing air, progressive hypoxia induced by closed circuit breathing and breathing 100% O2
were determined in 5 new migrators coming from low altitude to high altitude for 20_80 days
(group I ), 16 migrators from low altitude residing at high altitude for 3_20 years (group II) and
5 native highlanders at 4,750 m altitude. Ventilatory response was expressed as minute
ventilation to arterial O2 saturation ratio (VE/SaO2).Results _ While breathing room air,
VE/SaO2 in group I (0.18±0. 04) was significantly higher (P<0.01) than that in group _
(0.13±0.03) and group _(0.13±0.03), and the VE/SaO2 values of group _ and group _ were
essentially the same._ VE/SaO2 values of the 1st, 2nd, and 3rd minute closed circuit breathing in
group _ (0.20±0.04, 0.27±0.04, and 0.56±0.07) were significantly higher (P<0.05) than those in
