左旋精氨酸冠状静脉逆行灌注对rn猪心肌缺血损伤保护作用

摘要

Objective:This study is to explore the effect of L-arginine coronary vein retroperfusion on the size of myocardial infarction and plasma endothelin level in the experimental acute myocardial infarction model of the pig.Method:Three groups were subjected to 60 min ischemia by ligation of the anterior descending coronary artery and 3 hr reperfusion after loosening the ligation.The first group received L-arginine(1.5 mg*kg-1*min-1)coronary vein retroperfusion.The second group received I.V. infusion of L-arginine and the third,as the control group,was retroperfusion with normal saline.The infarct size was measured by the triphenyl tetrazolium chloride method.The blood samples for endothelin were withdrawn from coronary vein,peripheral artery and vein at eight different time.Result:The infarct size in the first group was 36%±7% of the myocardium at risk compared to 68%±7% in the saline control group.The infarct size was smaller in the i.v.infusion group than the control but has no statistical significance.The coronary vein endothelin level was lower than the other two groups.Conclusion:The reduction of myocardial size and coronary vein endothelin level in the retroperfusion of L-arginine group may be related to the increased formation of nitric oxide through L-arginine%目的：探讨冠状静脉逆行灌注左旋精氨酸对实验性急性心肌梗塞猪动物模型心肌梗塞面积及血浆内皮素的影响。方法：3组实验猪通过套扎冠状动脉前降支60 min形成急性心肌缺血，然后松解套扎线3 h产生再灌注。第一组左旋精氨酸(1.5 mg*kg-1*min-1)冠状静脉逆行灌注。第二组外周静脉接受同量的左旋精氨酸；第三组为对照组，冠状静脉逆行灌注同量的生理盐水。心肌梗塞面积通过三苯基四唑氯化物染色法测定。从冠状静脉、外周动脉、静脉八个不同时点采血测内皮素。结果：第一组心肌梗塞面积占危险区域心肌面积达36%±7%，显著低于对照组(68%±7%)。第二组心肌梗塞面积小于对照组，但无统计学意义。第一组冠状静脉血内皮素水平较其他两组低。结论：左旋精氨酸冠状静脉逆行灌注减少心肌梗塞面积和降低冠状静脉血内皮素水平，其可能与左旋精氨酸增加一氧化氮合成有关。