L-精氨酸、腺苷和组氨酸联用对未成熟心肌的保护作用  

Protective effect of combination use of L-arginine,adenosine,and histidine on immature myocardium

作　　者：敦静[1] 王伟[2] 龚琪[3] 王哲[3] 

机构地区：[1]河北医科大学第四医院手术室,石家庄050011 [2]河北省成安县人民医院外科 [3]河北医科大学第四医院胸心外科,石家庄050011

出　　处：《西南国防医药》2014年第4期356-358,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：河北省卫生厅科技支撑计划(20090458)

摘　　要：目的 评价传统心脏停搏液中加入L-精氨酸、腺苷与组氨酸对未成熟心肌保护的临床效果.方法 将60例体重8～18.5 kg的法洛四联症患者随机分成3组,分别应用含L-精氨酸（A组）、L-精氨酸＋腺苷（B组）和L-精氨酸＋腺苷＋组氨酸（C组）心脏停搏液灌注心脏,记录心脏自动复跳情况、术后正性肌力药物用量、呼吸机支持时间等指标.结果 主动脉开放后,C组自动复跳率、术后正性肌力药物用量、呼吸机支持时间均显著优于A组和B组（P＜0.05或P＜0.01）.结论 加入L-精氨酸、腺苷和组氨酸心脏停搏液,能显著减少正性肌力药物的用量及缩短呼吸机支持时间,较单用L-精氨酸或L-精氨酸＋腺苷心脏停博液效果更好.Objective To investigate the clinical protective effect of adding L-arginine,adenosine, and histidine in traditional cardioplegic solution on immature myoeardium. Methods Sixty patients with tetralogy of Fallot who weighted from 8 to 18.5 kg were randomly divided into three groups who received the cardiac perfusion with cardioplegie solution that containing L-arginine（ group A）, L-arginine plus adenosine （group B）, and L-arginine plus adenosine and histidine（ group C ）, respectively. It was recorded the reheating rate,postoperative inotropic medicine dosage, and ventilation support time, etc. Results After the opening of the aorta, the rebeating rate, postoperative inotropic medicine dosage, and ventilating support time in group C were all significantly superior to those in group A and B （ P 〈 0.05 or P 〈 0.01 ）. Conclusions Cardioplegic solution containing L-arginine, adenosine, and histidine can significantly reduce inotropie drug dosage and ventilator support time. The effect is better than that of eardioplegic solution containing only L-arginine or L-arginine plus adenosine.

关 键 词：法洛四联症 婴幼儿 心脏停搏液 组氨酸 效果 

分 类 号：R654.1[医药卫生—外科学]