L-精氨酸在婴幼儿心内直视手术中的心肌保护研究

Effect of L-arginine on myocardial protection in children's congenital heart disease

目的 :观察一氧化氮体内代谢的前提之一 -L 精氨酸在婴幼儿心脏手术中的心肌保护作用。方法 :48例先天性心脏病患者随机分为 3组 ,每组 16例 ,A组为对照组 ,常规温血停搏液。B组在其中加入R 精氨酸 ,C组加入L 精氨酸。各组病人选取不同时段测MDA ,CK及NO2 -/NO3 -,并用电镜观察左心房心肌细胞线粒体变化。结果 :C组MDA ,CK及NO2 -/NO3 -各指标 ,心肌细胞线粒体半定量测定积分与A、B组相比有明显差异 (P <0 0 5或P <0 0 1)。结论 :婴幼儿心脏手术中在温血停搏液中加入适量L -精氨酸 ( 3 0mg/kg)可有效改善内皮细胞一氧化氮代谢 。

Objective To study the effect of infusion to L arginine,a precursor of NO in children's heart surgery with warm blood cardiopegia.Methods Forty-eight patients undergoing operation were divided randomly into 3 groups.Group A(16 patients) underwent warm blood cardioplegia,group B underwent R arginine together with warm blood cardioplegia and group C underwent L arginine together with warm blood cardioplegia.MDA,CK and NO 2 -/NO 3 - were examined at different time and changes of mitochondrion of left artium myocardium were deteced by electrosocope.Results The content of MDA,CK and NO 2 -/NO 3 - and the score of mitochondrion in group C were statisically different from those in group A and B(P<0 05 or P<0 01).Conclusion L arginine,a precusor of nitric oxide in children's heart operation,could effectively protect myocardium.