L-精氨酸在体外循环过程中对心肌再灌注损伤的保护作用

Protective effect of L-arginine myocardial reperfusion injury during oardiopulmonary bypass

目的研究一氧化氮(NO)前体——L-精氨酸在体外循环过程中对心肌再灌注损伤的保护作用。方法将12条杂种犬随机分成对照组和实验组。常规建立体外循环,实验组中冷晶体停搏液内加L-精氨酸80mg/kg。于心脏停跳90分钟再灌注30分钟前后分别监测心功能,于左心室活检取心肌测NO合成酶(NOS)、丙二醛(MDA),抽取冠状窦血测肌酸磷酸激酶(CPK)、NO、可溶性细胞间粘附分子1 (sICAM-1)和可溶性血管细胞粘附分子1 (sVCAM-1)。结果两组再灌注后NOS下降;对照组的NO下降,实验组的NO变化无显著性;实验组与对照组相比,再灌注后,心功能恢复有明显改善,sICAM-1、sVCAM-1、CPK和MDA下降。结论在体外循环过程中,L-精氨酸对再灌注损伤心肌具有明显保护作用。

Objective In order to elucidate the effect of L- arginine on reperfusion injury during cardiopul- monary bypass. Methods 12 mongrel dogs were randomly divided into two groups: control group and ex- perimental group Cardiopulmonary bypass was conventionally instituted (cold crystalloid cardioplegia in experimental group with L- arginie 80mg/kg). Cardiac function was measured, specimens of left ventricu- lar tissue were biopsied to analyze the myocardial malonaldehyde (MDA)and NO Synthase (NOS)content , blood samples from coronary sinus were taken for changes of nitric oxide (NO), creatine phosphokinase (CPK), soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule- 1 (sICAM-1) before and after ischemic for 90 min followed by 30 min of reperfusion. Results NOS was found reduced after reperfusion in both groups. NO also decreased in the control group, but no changes in the experimental group. In the experimental group, compared with control group, the recovery of my- ocardial dysfunction was ameliorated and MDA. CPK, sVCAM-1 and sICAM-1 were found reduced after myocardial reperfusion. Conclusion Our study indicated that L-Arginine could have protective effect on myocardial reperfusion injury during cardiopulmonary bypass.