【摘要】 目的:比较在传统心脏停搏液中加入L-精氨酸、L-精氨酸与腺苷和L-精氨酸、腺苷与组氨酸对心肌缺血/再灌注损伤的保护作用。方法:将60例法洛四联症婴幼儿随机分成3组,分别应用含L-精氨酸(A组)、L-精氨酸加腺苷(B组)和L-精氨酸、腺苷及组氨酸(C组)心脏停搏液灌注心脏。检测血清肌钙蛋白I(cTnI)、肌酸磷酸激酶同工酶(CKMB)含量。结果:B组血浆cTnI含量仅于主动脉开放2h显著降低(P<0.01),C组不但于主动脉开放后30min、2h和6h均显著低于A组(P<0.01或P<0.05),而且于主动脉开放2h、6h显著低于B组(P<0.01或P<0.05);C组血浆CKMB含量于主动脉开放后30min、2h、6h均显著低于A组(P<0.01或P<0.05),而在2h、6h也显著低于B组(P<0.01或P<0.05)。结论:加入L-精氨酸、腺苷和组氨酸心脏停搏液能显著减少cTnI、CK-MB的释放,较L-精氨酸和L-精氨酸与腺苷心脏停博液效果更好。更多还原

【Abstract】 Objective:To compare the myocardial protective effect of three cardioplegic solution respectively added L-arginine,L-arginine and adenosine and L-arginine,adenosine and histidine in traditional cardioplegic solution.Methods:Sixty patients with tetralogy of Fallot were randomly divided into three groups,respectively,L- arginine(group A),L- arginine plus adenosine(group B)and L- arginine, adenosine and histidine(group C).Serum levels of troponin I(cTnI),creatine kinase isoenzyme(CKMB) content were tested in different time-point.Results:Plasma cTnI content in group B only significantly decreased(P<0.01)2hafter opening aortic,group C plasma cTnI was significantly lower than that of group A(P<0.01or P<0.05)not only in 30min,2hand 6hafter opening aorta,but also significantly lower than those of group B after opening aortic 2hand 6h(P<0.01or P<0.05).Plasma content of CKMB in group C were significantly lower than that in group A in 30min,2hand 6hafter opening aorta(P <0.01or P<0.05),and were significantly lower than that of group B(P<0.01or P<0.05)in the 2h and 6h.Conclusion:L-arginine,adenosine and histidine cardioplegic solution can significantly reduce cTnI,CKMB release,which has better effect than L-arginine and L-arginine and adenosine cardioplegic solution.更多还原