含左旋精氨酸的心肌保护液对冠状动脉旁路移植术中氧摄取量的影响  

Effects on the rate of myocardial oxygen uptake with the supplyment of L-arginine in cardiaoplegia during coronary artery bypass graft surgery

作　　者：牛兆倬 池一凡 陈晓伟 侯文明 孙勇 孙忠东 孙龙 

机构地区：[1]青岛市立医院心脏中心心外科,青岛266071

出　　处：《心肺血管病杂志》2012年第3期296-298,共3页Journal of Cardiovascular and Pulmonary Diseases

基　　金：青岛市2008年度医药科研指导计划立项课题(编号:2008-wszd014)

摘　　要：目的:了解含左旋精氨酸(L-Arg)的心肌保护液对冠状动脉旁路移植术中心肌氧摄取率的影响。方法:20例患者随机分为2组,每组10例。对照组:常规心肌保护液组,不添加L-Arg。实验组:每1 000 mL改良托马斯液中加入7.5 g L-Arg。记录2组患者阻断主动脉前(T1)、主动脉开放后5min(T2)、主动脉开放后20 min(T3)桡动脉(A)和冠状静脉窦(CS)回流血中氧分压、血氧饱和度,计算心肌氧摄取率,记录术后12 h(T4)、术后24 h(T5)、术后48 h(T6)心肌酶CK-MB和cTnI指标。结果:20例患者无手术死亡,均痊愈出院。实验组氧摄取率高于对照组。结论:添加一定浓度L-Arg能够提高心肌保护液在冠状动脉旁路移植术中心肌保护效果。Objective：To evaluate the effects of L-arginine in cardioplegia during coronary artery bypass graft（CABG） surgery.Methods： 20 patients undergoing CABG surgery were randomized in 2 groups.The control group（n=10） was administered a placebo injection in the blood cardioplegia,the study group（n=10） received an injection of 7.5g L-arginine in every 1 000mL developed St.Thomas cardioplegia.Blood samples from the ascending aorta and the coronary sinus catheter were collected before aortic cross-clamping（T1）,5 minutes after reperfusion（T2） and 20 minutes after reperfusion（T3）.The rate of myocardial oxygen uptake were calculated.The concentration of CK-MB and cTnI were recorded at 12 hours（T4）,24 hours（T5）,and 48 hours after the operation（T6）.Clinical data were recorded.Results：All patients discharged from the hospital healthy and there were no serious complications.The patients in the study group had higher level of myocardial oxygen uptake rate and lower level of CK-MB and cTnI.There were no significant difference in the ICU stay time.Conclusion：Cardioplegic solution supplemented with L-arginine can improve the effects of myocardial protection during CABG surgery.

关 键 词：心肌保护 冠状动脉旁路移植术 L-精氨酸 氧摄取率 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]