左旋精氨酸对犬深低温停循环脑氧代谢的影响  

Influence of L-arginine on cerebral oxygen metabolism during deep hypothermic circulatory arrest in dogs

作　　者：高勇[1] 邹小明[2] 王武军[2] 刘亚湘[2] 毛向辉[2] 

机构地区：[1]南方医科大学南方医院急诊科,广州510515 [2]南方医科大学南方医院胸外科,广州510515

出　　处：《中华神经医学杂志》2008年第6期577-580,共4页Chinese Journal of Neuromedicine

摘　　要：目的利用犬深低温停循环（DHCA）动物模型，研究左旋精氨酸（L—arg）预处理对DHCA不同时期犬脑氧代谢及超微结构的影响。方法健康成年杂种犬15只，分为3组，即对照组；L-arg预处理组：停循环前60min给予L-arg100mg／kg预处理；联合处理组：停循环前60min给予L—arg100mg／kg、7-硝基吲唑（7-Ni）25mg／kg联合处理，每组各5只。按I临床方法建立体外循环转流降温至鼻咽部温18cc停循环，90min后恢复循环复温。分别于停循环前30min、停循环时（0min）、停循环45min、停循环90min、复温再灌注60min抽取颈静脉、颈动脉血测颈静脉血氧饱和度（SjvO2）、一氧化氮（N0）。实验犬处死时颈动脉灌注4％多聚甲醛固定，取脑皮质、海马行透射电镜观察脑组织超微结构。结果L-arg预处理和联合处理均可增加血浆NO含量、提高DHCA期SjvO2，改善脑氧代谢，减轻脑超微结构损害。停循环前血浆NO与停循环后SjvO：呈正相关（r=0．679，P=0．005）。结论DHCA前给予L—arg预处理有较好的脑保护效果。Objective To investigate the effect of L-arginine （L-arg） on cerebral oxygen metabolism and ultrastructure during deep hypothermic circulatory arrest （DHCA） in experimental dogs. Methods Fifteen healthy adult mongrel dogs with both sexes, weighing （14.7±2.4） kg,were randomly divided into three groups （n=5）： sham treated group, L-arg pretreated group （100 mg/kg L-arg was given 60 min before circulation arrest）, L-arg and 7-Ni combined treated group （100 mg/kg L-arg and 25 mg/kg 7-Ni were given 60 min before circulation arrest）. Extracorporeal circulatory was established routinely, and DHCA commenced when the nasopharyngeal temperature was reduced to 18℃, then reperfusion began after 90 min ofDHCA. SjvO2, NO in plasma were measured 30 min before DHCA and 0, 45, 90 min after DHCA commencement and 60 min after rewarming. The ultrastructural changes of cortex and hippocampal gyrus were also been observed with transmission electron microscope after the dogs were executed. Results Compared with sham-treated group, L-arg pretreatment combined with 7-Ni or not increased NO content in plasma, SjvO2 during DHCA , improved cerebral oxygen metabolism and reduced brain ultrastructural injury. There was a positive correlation between NO conten in plasma before arrest and SjvO2 after arrest （r=0.679,P=0.005）. Conclusion L-arg pretreatment has cerebral protective effects and can improve cerebral oxygen metabolism during DHCA.

关 键 词：体外循环 深低温停循环 左旋精氨酸 7-硝基吲唑 颈静脉血氧饱和度 

分 类 号：R654.1[医药卫生—外科学]