The Effect Of Intravenous Drip L-arginine On Serum NO,Plasma ET-1 And PASP Levels During Perioperatively For The Patients With Congenital Heart Disease Complicated With Pulmonary Hypertension

Objective To discuss the effect of Intravenous dripping L-arginine(L-Arg) on serum NO,plasma ET-1 and PASP levels during perioperatively for the congenital heart disease(CHD) children complicated with pulmonary hypertension(PH).Methods 40 CHD children complicated with PH were divided randomly into two groups,1-Arginine treatment group(n=20)and control group(n=20).In treatment group the patients received 1-arginine 400mg/kg(which was added into 5%glucose solution in 100ml)by intravenous drip once a day for one week.In control group the patients received 5%GS 100ml in which nothing was added.Blood samples were taken from two groups on admission(T₁),before cutting skin(seven days after hospitalization T₂),at the end of surgery(T₃),6 hours after surgery(T₄),12 hours after surgery(T₅) for determination the concentration of NO in serum and ET-1 in plasma.Examing the pulmonary arterysystolic pressure of the two groups(PASP) at T₁ and T₂.Results No significant differences were fond of all the measurements at T₁(P＞0.05). NO concentration was significantly increased at T₂-T₅ compared with T₁(P＜0.05) in treatment group and declined at T₃-T₄ compared with T₁(P＜0.05) in control group, the two groups have significantly differences at T₂-T₅(P＜0.05).ET-1 concentration was significantly declined at T₂-T₅(P＜0.05) in treatment group and increased at T₃-T₅ in control group(P＜0.05),the two groups have significantly differences at T₂-T₅ (P＜0.05).Compared with T₁ PASP level was significantly declined at T₂ in L-Arginine group(P＜0.05) and PASP level has significantly difference at T₂ in the two groups(P＜0.05).Conclusion Open heart operation during cardiopulmonary bypass(CPB) play an important role in breaking the Endothelial Cells and accelerate it secreting more ET-1,and depleting the NO in serum.Intravenous drip 1-arginine is effective decreasing the plasma concentration of ET-1 and increasing the serum concentration of NO for the patients who get CHD complicated with PH,so it has effect on preserving the vascular endothelial cells and decreasing the PH levels in clinic.