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目的研究左旋精氨酸对心脏移植物血管病变的抑制作用及其机制.方法采用大鼠异位心脏移植模型.对照组26只,移植后不用左旋精氨酸;实验组21只,移植后按每天800mg/kg将左旋精氨酸加入饮水中.于移植后2个月和3个月检测各组的心脏移植物血管病变评分和血浆一氧化氮含量.结果移植后2个月,实验组的移植物存活率为90.5%,显著高于对照组的61.5%(P<0.05).移植后2个月和3个月,实验组血浆一氧化氮均显著高于对照组,分别为(105.37±10.66)μmol/L vs (68.54±6.83)μmol/L(P<0.05),和(104.53±12.31)μmol/L vs (66.32±10.54)μmol/L(P<0.05);而对照组心脏移植物血管病变评分显著高于实验组,分别为2.4±0.7 vs 1.1±0.6(P<0.05),和3.0±0.8 vs 1.6±0.9(P<0.05).实验组心脏移植物的冠状动脉内膜病变轻微,内皮和内弹力层基本保持完整,平滑肌细胞增殖不明显.结论补充左旋精氨酸可改善心脏移植物血管病变,其机制与一氧化氮合成增加有关.一氧化氮具有保护内皮功能,抑制平滑肌细胞增殖的作用.“,”Objective To explore the inhibitory effect of L-arginine on cardiac allograft vasculopathy (CAV) and its possible mechanisms.Methods The rat cardiac allograft model was used.In the control group (n=26),L-arginine was not administered after heterotopic cardiac transplantation,and the other 21 rats (experimental group) received administration L-arginine (800mg/kg every day,in drinking water) after heart transplantation.CAV score was evaluated and plasma nitric oxide (NO) was measured 2 and 3 months after transplantation.Results Graft survival 2 months after transplantation was significantly (P<0.05) higher in experimental group (19 of 21,90.5%) than that in control group (16 of 26,61.5%).The plasma NO was significantly higher in experimental group than that in control group both at 2nd month (105.37±10.66)μmol/L vs (68.54±6.83)μmol/L(P<0.05),and 3rd month (104.53±12.31)μmol/L vs (66.32±10.54)μmol/L(P<0.05),after transplantation.CAV score was significantly higher in control group than that in experimental group both at 2nd month 2.4±0.7 vs 1.1±0.6(P<0.05),and 3rd month 3.0±0.8 vs 1.6±0.9(P<0.05),after transplantation.The cardiac allografts in experimental group showed minimal intimal proliferation,the endothelium and internal elastic lamina remained almost intact,and reduced smooth muscle cell proliferation.Conclusion Dietary L-arginine attenuates CAV.The protective effect may relate to the generation of NO to maintain endothelial function and direct inhibit smooth muscle cell proliferation.