【摘要】 目的探讨改良心肌保护液对婴幼儿心肌保护作用。方法婴幼儿室间隔缺损修补术30例,随机分为试验组15例(改良心肌保护液),对照组15例(单纯冷晶体停搏液),分别观察主动脉开放后心脏自动复跳率,机械辅助通气时间和ICU停留时间,术后正性肌力药物辅助情况,并于转流前、主动脉开放后30min,术后3、24、72h分别抽血测定肌酸肌酶(MB isoenzyme of creatine kinase,CK-MB)、肌钙蛋白T(cardiac troponin T,cTnT)。结果试验组心脏自动复跳率明显高于对照组(P<0.05),术后机械辅助通气时间和ICU停留时间、多巴胺用量均低于对照组(P<0.05),在主动脉开放后30min、术后3、24、72h血浆CK-MB、cTnT水平明显降低,与对照组相比,差异有统计学意义(P<0.01)。结论加入L-精氨酸的改良心肌保护液对婴幼儿未成熟心肌具有明显保护作用。更多还原

【Abstract】 Objective To investigate the protective effects of L - arginine ( L - Arg) on myocardial ischemia reperfusion injury during open heart surgery under cardiopulmonary bypass ( CPB). Methods Thirty patients with congenital ventricular septal defect were randomly divided into L - Arg group (n = 15) received L - Arg 4 g/L in cardioplegic solution and control group (n = 15) received saline solution in the same mode.Before aortic - clamping,30 min after opening aorta,3,24 and 72 h after termination of CPB,blood samples in artery were taken for the measurements of cardiac troponin T ( cTnT) and MB isoenzyme of creatine kinase ( CK - MB ).Results The L - Arg group could significantly lower the increase of cTnT and CK - MB.Postoperatively duration of mechanical assistant ventilation and detention time in ICU were shorter in the L - Arg group,and the usage amount of dopamine was less.Conclusion L - Arg has notable protective effect on ischemia reperfusion myocardium in the immarture heart during open heart surgery under CPB.更多还原