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目的：探讨先天性心脏病患者体外循环（CPB）期间心脏迷走神经变化对心肌再灌注损伤的影响，并阐明迷走神经拮抗剂-山莨菪碱（654-2）的心肌保护作用。方法：58例先心病患者随机均分为两组：使用常规心肌保护液为对照组，在常规心肌保护液中加入654-20．5ing／kg为用药组，分别测定不同手术时期两组冠状窦血中乙酰胆碱（Ach）、Ca2+及过氧化脂质（Lpo）含量，经Swan－Ganz导管测定心排量（CO）变化。结果：再灌注时及转流后对照组冠状赛血中彻Ach、Ca2+和Lpo含量明显增高（P＜0．o1，P＜0．001），与用药组比较具有显著性差异（P＜0．05，P＜0．o1）；转流后用药组的心排量稍有增加，但与对照组比较也有显著性差异（P＜0．01）。结论：Ach在CPB再灌注期间释放增多，在心肌停跳液中加入654－2可抑制迷走神经活动，增加心排血量，从而有效地防治心肌再灌注损伤，保护心脏功能。
Objective: To investigate the effect of cardiac vagal changes on myocardial reperfusion injury in patients with congenital heart disease during cardiopulmonary bypass (CPB) and to elucidate the cardioprotective effect of vagal antagonist anisodamine (654-2). Methods: 58 cases of patients with congenital heart disease were randomly divided into two groups: conventional cardioprotective solution as the control group, conventional cardioprotective solution was added 654-20.5ing / kg for the treatment group, were measured at different stages of coronary sinus Blood levels of acetylcholine (Ach), Ca2 + and lipid peroxidation (Lpo) were measured by Swan-Ganz catheter changes in cardiac output (CO). Results: The contents of Ach, Ca2 + and Lpo in the coronary blood of the control group at reperfusion and after reperfusion were significantly higher than those of the control group (P <0. 01, P <0.001) .05, P <0.O1). After transcatheter treatment, the cardiac output increased slightly, but there was also a significant difference compared with the control group (P <0.01). CONCLUSION: Ach is released during CPB reperfusion. Adding 654-2 to cardioplegia can inhibit vagal activity and increase cardiac output, which can effectively prevent myocardial reperfusion injury and protect cardiac function.