开心手术转流前静脉使用左旋精氨酸对肺动脉压的影响

目的 :观察在开心手术转流前静脉使用左旋精氨酸对肺动脉压的影响。方法 :将 2 0例先天性心脏病患者 ,随机分为实验组和对照组 ,每组 10例。实验组在开心手术转流前静脉使用左旋精氨酸 (2 0 0mg·kg- 1 )。在手术前后测定平均肺动脉压及肺静脉血内皮素 1和NO浓度。结果 :实验组体外循环术后平均肺动脉压低于对照组(P <0 .0 5 ) ,NO水平高于对照组 (P <0 .0 5 ) ,内皮素 1水平低于对照组 (P <0 .0 5 )。结论 :开心手术转流前静脉使用左旋精氨酸可提高再灌注时NO的水平 ,抑制ET 1水平升高 ,减少肺内白细胞聚集 ,具有降低肺动脉压的作用。

Decrease of pulmonary artery pressure by the infusion of L-arginine before cardiopulmonary bypass

Objective To investigate the influence and mechanism of L arginine(L Arg) on pulmonary artery pressure before cardiopulmonary bypass(CPB). Methods Twenty patients with congenital heart disease were randomly divided into the control group (n=10) and the L Arg group (n=10). The patients of the control group were injected with 10% glucose solution, while the patients of the L Arg grup were injected with L arginine (200 mg·kg -1 ) before the CPB operation. We measured the mean pulmonary artery pressure (mPAP), and the concentrations of nitric oxide (NO) and endothelin 1(ET 1) before and after the CPB operation. Results The mPAP of the L Arg group was lower than that in the control group after the CPB operation (P<0.05), the concentration of NO was higher in the L Arg group than that in the control group (P<0.05), and the concentration of ET 1 was lower in the L Arg group than that in the control grup (P<0.05). Conclusion The application of L Arg before the CPB operation can upgrade the concentration of NO, suppress ET 1 production after the operation, decrease white blood cell congestion in the lung, and reduce mPAP.