Nonami Y
Department of Surgery II, Kochi Medical School, Japan.
Surg Today. 1997;27(7):583-92. doi: 10.1007/BF02388212.
The release of nitric oxide (NO) from coronary endothelial cells is impaired following reperfusion; however, several experimental studies have found that it exerts a cardioprotective effect during myocardial ischemia-reperfusion. Thus, attempts have been made to supplement NO production exogenously during reperfusion when endogenous NO release may be diminished. Conversely, other studies suggest that NO exacerbates reperfusion injury by inducing the production of peroxynitrite. NO has also been reported to provide beneficial effects as a selective pulmonary vasodilator to relieve pulmonary hypertension. A loss of NO-mediated relaxation caused by the dysfunction of endothelial cells is characteristic of intimal hyperplasia, and nitrosovasodilators have proven efficient against atherosclerotic coronary heart disease, which may be attributable to their antiplatelet effects as well as to vasodilation. Furthermore, protamine sulfate, which is rich in L-arginine, is thought to augment NO production by supplying exogenous L-arginine, or to act on endothelial cell receptors to stimulate the production of NO. This review summarizes the current role of NO in cardiac surgery.
再灌注后冠状动脉内皮细胞一氧化氮（NO）的释放受损；然而，多项实验研究发现，它在心肌缺血-再灌注期间发挥心脏保护作用。因此，当内源性NO释放可能减少时，人们尝试在再灌注期间外源性补充NO生成。相反，其他研究表明，NO通过诱导过氧亚硝酸盐的产生而加重再灌注损伤。据报道，NO作为一种选择性肺血管扩张剂可缓解肺动脉高压，具有有益作用。内皮细胞功能障碍导致的NO介导的舒张功能丧失是内膜增生的特征，亚硝基血管扩张剂已被证明对动脉粥样硬化性冠心病有效，这可能归因于它们的抗血小板作用以及血管舒张作用。此外，富含L-精氨酸的硫酸鱼精蛋白被认为可通过提供外源性L-精氨酸来增加NO生成，或作用于内皮细胞受体以刺激NO的产生。本综述总结了NO在心脏手术中的当前作用。
