左旋精氨酸在冠脉搭桥术中心肌保护效果研究

目的：通过在心脏停搏液中添加适量左旋精氨酸来观察其在冠脉搭桥术中心肌保护效果。方法：选择2008年1月~2010年1月在我院行冠状动脉旁路移植术患者20例，随机分为2组，每组10例，对照组：常规心肌保护液组，不添加左旋精氨酸。实验组，心肌保护液中加入7．5gm左旋精氨酸。测患者术前（T1）、术后6小时（T2）、术后12小时（T3）、术后24小时（T4）、术后48小时（T5）血浆中TNF-α、IL-6、IL-8及cTnI含量。记录临床观察指标。结果：两组血浆TNF-α、IL．6、IL-8、cTnI浓度术前无统计学意义（P〉0．05），术后各时点TNF-α、1L-6、IL．8、cTnI浓度显著升高且实验组均低于对照组（P〈0．05）。临床观察指标除血管活性药物应用情况实验组优于对照组（P〈0．05）外无明显差异。结论：在心脏停搏液中加入L-精氨酸，可有效保护缺血心肌，减轻心肌再灌注损伤程度。

Assessing Myocardial Protective Effects of L-arginine in CABG

Objective： To investigate the myocardial protective effects of L-arginine in coronary artery bypass grafting. Methods： Between January 2008 and January 2010 twenty patients with unstable angina undergoing CABG were randomized to a study and a control group, that is, L-arginine group （n=10） and control group （n=10）. L-arginine was added to cardioplegia solutions in study group. A cold cardioplegic blood solution with 7.5g/L L-arginine infused for controlled reperfusion. Control patients received same protocol without L-arginine. Plasma levels ofTNF-α , IL-6, IL-8 and cTn I were measured at baseline （before operation T1）, and at 6（T2）, 12（T3）, 24（T4）and 48h（T5） after operation. Clinical parameters were observed and compared. Resulta： Plasma levels of TNF-α , IL-6, IL-8 and cTn I had no significant difference at T1 （P〉O.05）and were significantly higher at T2,T3,T4,T5 than T1. Plasma levels of TNF-a , IL-6, IL-8 and cTn I were significantly higher in control group at T2,T3,T4,T5 （P〈0.05）. Clinical parameters had no significant difference except that the dose of positive inotropic medicine at post operative in study group was much lower than control group （P〈0.05）. Conclusion： The results suggest that L-arginine added to the cardioplegic solution offer better myocardium protective effect and diminish ischemia reperfusion injury.