目的 观察左旋精氨酸(L-Arg)及超氧化物歧化酶(SOD)在大鼠心肌缺血再灌注损伤中的作用.方法 40只大鼠完全随机分为L-Arg组、SOD组、L-Arg SOD组及对照组各10只.在心肌缺血再灌注期间分别给予含L-Arg、SOD、L-Arg+SOD及不含L-Arg和SOD的KH灌注液,期间测定心脏功能指标、乳酸脱氢酶、肌酸磷酸激酶、一氧化氮、心肌组织丙二醛含量.结果 心肌缺血再灌注期间,各组间心率差异无统计学意义.L-Arg组左心室内压力高于对照组[分别为(71.2±3.7)mm Hg和(52.3±4.3)mm Hg],冠状动脉流量也高于对照组[分别为(87.4±13.5)ml/min和(64.2±11.2)ml/min](P<0.05);SOD组左心室内压力[分别为(74.3±3.4)mm Hg]也高于对照组(P<0.05),L-Arg+SOD组左心室内压力[(78.6±3.2)mmHg]和冠状动脉流量高于L-Arg组和SOD组,差异有统计学意义(P<0.05).在缺血再灌注10 min时,L-Arg组和SOD组乳酸脱氢酶、肌酸激酶均较对照组减少(P<0.05),L-Arg+SOD组乳酸脱氢酶、肌酸激酶均较L-Arg组和SOD组减少(P<0.01);L-Arg组冠状动脉流出液NO含量高于对照组(P<0.05);SOD组冠状动脉流出液NO含量和对照组相比差异无统计学意义;L-Arg+SOD组略高于L-Arg组,但差异无统计学意义.与对照组相比,SOD组、L-Arg+SOD组心肌丙二醛含量均明显降低(P<0.01),但这2组间差异无统计学意义.L-Arg组心肌丙二醛含量和对照组相比,差异无统计学意义.结论 L-Arg和SOD在心肌缺血再灌注损伤中有保护作用,二者联合效果更明显.%Objective To observe the effect of L-arginine (L-Arg) and superoxide dismutase (SOD) on the myocardial ischemia-reperfusion injury. Methods KH perfusion fluid containing L-Arg, SOD and L-Arg+ SOD was given during the period of myocardial ischemi-reperfusion. Cardiac function, lactate dehydrogenase (LDH), creatine phosphokinase (CPK), Nitric oxide (NO) and the content of myocardial malondialdehyde (MDA) was ob-served. Results During the period of myocardial ischemia-repedusion, left ventricular pressure (LVP) and coro-nary flow(CF) in L-Arg group was higher than those in control group. LVP in SOD group was higher than control group. At the same time, LVP and CF in L-Arg+SOD group were significantly higher than those in L-Arg group and SOD group(P<0.05). At 10 minutes after reperfusion, LDH and CPK in L-Arg group and SOD group were less than those in control group, while those in L-Arg+SOD group were significantly less than L-Arg group and SOD group. Compared with control group, MDA level in SOD group and L-Arg+SOD group were significantly lower(P< 0.01). Conclusion L-Arg and SOD alleviate the myocardial ischemia-reperfusion injury. A combined therapy showes better therapeautic effect than single use of L-Arg or SOD.
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