Protective Effects Of L-Arginine On Myocardium In Patients Undergoing Open Cardio-pulmonary Bypass

OBJECTIVE:To investigate the myocardial protective effect of L-arginine added into cardioplegic solution used in CPB. METHODS:A total of67patients with cardiac operation patients by ECC were divided into two groups, research group (L-Arg added into cardioplegic solution,32cases) and control group (saline solution added into cardioplegic solution,35cases), according to the conposion of cardioplegic solution. The methods of anesthesia, and ECC for the two groups were same. The time of ECC, clamping of aorta circulation (ACC), mechanical ventilation (MV), induction of cardiac arrest and the rate of spontaneously resume heart beating were compared between two groups. Blood samples were taken from artery after induction of anesthesia (To),30min after opening aorta (T1),6h (T2) and24h (T3) after termination of ECC for testing the level and change of cTnl, CKMB and LDH. RESULTS:1) There was no significant difference in the levels of CK-MB, LDH and cTnl before and after anaesthesia between the wo groups.But the levels of CK-MB, LDH and cTnl at6h and24h after aortic declamping were significantly lower in study group than that in control group (P<0.05) Compared to control group, the time of cardiac arrest induction in research group was shorter (P=0.025), the rate of spontaneously resume heart beating in research group was higher (P=0.037), but the time of ECC, ACC and MV was no difference between two groups.The contents of myocardial enzymogram at To were no significant differences between the two groups.However, the above contents were significantly lower in research group than that in control group (P<0.05) from T1moment. Follow with the increasing of ECC time, the contents of myocardial enzymogram were also increasing, and the above contents were highest in two groups at T3moment (P<0.05)..2) The supplementary time of group C was significant longer than that of group L (P<0.05). The ratio of myocardial auto-resuscitation in group L was significant higher than that in group C (P<0.05). CONCLUSION:The results suggest that L-arginine added to the cardioplegic solution offers better myocardium protective effect in CPB.