左旋精氨酸对心肌结构的影响  

Effect of L-arginine on Protection of Myocardial Structure

作　　者：叶磊[1] 胡克剑[1] 夏利民[1] 贺伯明[2] 姜桢[3] 蒋振斌[1] 王春生[1] 陈志强[1] 

机构地区：[1]上海医科大学附属中山医院心外科,200032 [2]上海医科大学附属中山医院内科实验室,200032 [3]上海医科大学附属中山医院麻醉科,200032

出　　处：《中华创伤杂志》1999年第2期124-126,共3页Chinese Journal of Trauma

摘　　要：目的研究左旋精氨酸对缺血／再灌注损伤心肌肌钙蛋白的影响。方法１４例行双瓣膜替换术患者，随机分成对照组（单晶体停搏液）和实验组（左族精氨酸晶体停搏液），于主动脉阻断前，开放后５，３０分钟及１，２，２４，４８小时测定亚硝酸盐／硝酸盐；阻断前、开放后５分钟，１，２，２４，４８小时测定心肌肌钙蛋白Ｔ。结果（１）对照组开放后即下降，３０分钟后与阻断前相比有明显差异（Ｐ＜０．０５）；（２）实验组主动脉开放后即明显上升（Ｐ＜０．０５），６０分钟时达高峰；（３）实验组主动脉开放后２，２４小时心肌肌钙蛋白Ｔ显著低于对照组（Ｐ＜０．０１）；（４）对照组开放前１分钟线粒体改变明显重于实验组（Ｐ＜０．０１）。Objective To study the effect of L-arginine on protection of myocardialStructure. Methods in this StUdy, 14 patients undergoing bivalve replacement were divided in- to two gnure: the control coup (group C) and the exrerimental group (abut E). At the timebefore aortic block and 5 minutes,30 minutes,1, 2, 24 and 48 hours after clearing aorticblock, blood was taked to measure the concentrations of [NO2-]/[NO3-];,and at the time beforeaortic block, and 5 Ininutes, 1, 2, 24 and 48 hours after clearing aortic block the concentfationsof cardic Troponin T (cTnT) were measured. At the moment of aortic block and releasingaortic block, tissues were taken from the left atrium and had electron-Inicroscopic examination.Results After releasing aotic-block, there were differences in concentrations of [NO2-]/[NO3-]between the two groups:in group C, it began to decrease at the the of releasing aortic block,30 minutes later it decreased significantly compared with that of the time of bore aortic block(P<0.05); in group E, it increased at the time of releasing aortic block(P<0.05), 60 minutes laterit increased to the peak. Two and 24 hours after releasing the aortic clamping, the values ofcTnT in group E were lower than that in group C (P<0.01). The results of eledron-microscopeshowed that the mitochondrial in the group E was maintained better than that in the groupC(2.335±0.889 vs 2.725±0.832, P <0.01). Conclusions L-argirilne can probest myocardiumstrUcture effectively during ischelnia/reperfusion.

关 键 词：心肌缺血 再灌注损伤 心内直视手术 左旋精氨酸 

分 类 号：R654.2[医药卫生—外科学]