左旋精氨酸对心内直视手术期间血清心肌肌钙蛋白T的影响

目的 探讨左旋精氨酸(L-Arg)对心肺转流期间心肌缺血-再灌注损伤的保护作用.方法 拟行心内直视手术的先天性心脏病患者30例,随机均分为L-Arg组(L组)和对照组(C组).L组于主动脉开放后给予L-Arg 200 mg/kg.分别于主动脉插管时、主动脉开放后30 min、2、6 h检测心肌肌钙蛋白T(cTnT)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、丙二醛(MDA)含量和超氧化物歧化酶(SOD)活力.结果 主动脉开放后两组cTnT比主动脉插管时显著升高(P＜0.01),L组cTnT在主动脉开放后2、6 h显著低于C组(P＜0.05).与C组比较,L组主动脉开放后2 h血浆cTnT、LDH、CK-MB和MDA的上升幅度显著降低(P＜0.05或P＜0.01),SOD活性显著升高(P＜0.05).结论 L-Arg对心内直视手术期间心肌有良好的保护作用.

Effect of L-arginine on cardiac troponin T during open heart surgery under cardiopulnonary bypass

Objective To investigate the protective effects of L-arginine(L-Arg) on myocardial ischemia-reperfusion injury during open heart surgery under cardiopulmonary bypass(CPB).MethodsThirty patients with congenital ventricular septal defect or atrial septal defect were randomly divided into L-Arg group(L) and control group(C) with 15 cases each.L-Arg 200 mg/kg was administered after aortic-off clamping in group L.Before aortic-clamping and at 30 min,2,6 h after aortic-off clamping,blood samples were taken for the measurements of cardiac troponin T(cTnT),lactate dehydrogenase(LDH),MB isoenzyme of creatine kinase(CK-MB),malondialdehyde(MDA) and the activity of superoxide dismutase(SOD).Results The treated group could significantly lower the increase of cTnT,LDH,CK-MB and MDA was less,and the increase the activity of SOD was more in group L than those in group C.Conclusion L-Arg has notable protective effect on ischemia-reperfusion myocardium during open heart surgery under CPB.