左旋精氨酸在房间隔缺损合并肺动脉高压术中的肺保护研究  

Pulmonary Protection of L-arginine in Adult Patients with Atrial Septal Defect Complicated with Pulmonary Hypertension

作　　者：李树斌[1] 李俊杰[1] 李斌[1] 

机构地区：[1]新乡市中心医院心胸外科,河南新乡453000

出　　处：《河南科技大学学报（医学版）》2017年第2期110-112,共3页Journal of Henan University of Science & Technology:Medical Science

摘　　要：目的探讨左旋精氨酸在成人房间隔缺损合并肺动脉高压术中的肺保护作用。方法随机选取患者52例,观察组26例,对照组26例。观察组在体外循环预充液中加入左旋精氨酸200 mg·kg^(-1),对照组则加入等量生理盐水。分别于手术的不同时间点进行数据监测:(1)两组体外循环时间及辅助通气时间;(2)肺动脉平均压监测(PAMP);(3)计算氧合指数;(4)血浆超氧化物歧化酶(SOD)浓度测定。用SPSS 13.0统计软件包进行统计处理。结果两组患者体外循环时间差异无统计学意义(P>0.05),辅助通气时间差异有统计学意义(P<0.05)。肺动脉平均压、氧合指数、血浆SOD浓度在主动脉开放后5 min、主动脉开放后4 h、主动脉开放后24 h,两组比较均有统计学意义(P<0.05)。结论在房间隔缺损合并肺动脉高压的患者行手术的同时使用左旋精氨酸能拮抗肺的缺血再灌注损伤、改善肺的氧合,有良好的肺保护作用。Objective To study the pulmonary protection of L-arginine in adult patients with atrial septal defect complicated with pulmonary hypertension. Methods 52 patients were randomly divided into observation group and control group, with 26 patients in each group. L-arginine（200 mg·kg^-1） was added to cardiopulmonary bypass priming solution in the observation group and equal amount of normal saline was added in the control group. Data were monitored at different time points of surgery, including extracorporeal circulation time, ventilation time, pulmonary artery mean pressure （PAMP）, oxygenation index and the concentration of superoxide dismutase （SOD）. SPSS 13. 0 statistical package was used in statistical processing. Results There was no statistically significant differences between two groups of patients with extracorporeal circulation time （P 〉 0.05 ）. But observation group was better than control group in ventilation time（P 〈 0.05）. There was a significant difference in the levels of PAMP, oxygenation index, and SOD at the time of 5 minutes, 4 hours and 24 hours after aortic opening（P 〈 0.05）. Conclusion Application of L-arginine in adult patients with atrial septal defect complicated with pulmonary hypertension could protect the lung tissue, relieve ischemia reperfusion injury and improve oxygenation of the lung.

关 键 词：左旋精氨酸 成人 房间隔缺损 肺保护 

分 类 号：R654.2[医药卫生—外科学]