L-精氨酸对体外循环病人术后血浆TNF-α水平的影响及意义

Effects of L-Arginine on Plasma Level of TNF-αAfter Cardiopulmonary Bypass

将51例拟行心脏瓣膜置换手术的风湿性心脏病患者术前随机分成两组1)处理组(A组,n=25),术中给予300mg/kgL-精氨酸治疗;2)对照组(B组,n=26).分别于术前、体外循环(CPB)停机后2h及CPB停机后24h用酶联免疫吸附法测定两组血浆肿瘤坏死因子(TNF)-α浓度.发现两组病例CPB后2h及CPB后24hTNF-α水平与同组术前基础值比较有显著的升高(P<0.05);CPB后24hTNF-α水平,A组与B组比较有显著性降低(P<0.05).提示CPB可引起促炎症细胞因子TNF-α血浆水平的显著性升高;L-精氨酸可以降低CPB术后TNF-α血浆水平,具有抗炎作用.

patients with rheumatic heart disease were divided into two groups randomly:1) treated group (group A,n=25),given L arginine at 300 mg/kg during operation;2) control group (group B,n=26).Plasma level of TNF αwas measured by enzyme linked immunosorbent assay technique at baseline(before operation) and at 2,24 hours after cardiopulmonary bypass(CPB) termination.It displayed that a significant (P<0.05) increase of TNF αoccured in both groups at 2 and 24 hours after CPB when compared with the same group at baseline before CPB;In group A,TNF αlevel was significantly lower than in group B (P<0.05) at 24 hours after CPB.It implied that CPB induced a significant increase of cytokine TNF αafter CPB;L arginine decreased plasma level of TNF αafter CPB and has the antiinflammatory effect.