L-аргинин как новый инструмент в интенсивной терапии сердечно-сосудистых расстройств: систематический обзор литературы

Авторы:

Ионас Стасио Симутис,

Никита Юрьевич Семиголовский,

Игнат Геннадьевич Лобаченко,

Александр Анатольевич Сапегин,

Марк Самуилович Данилов,

Эйнар Салихович Юсупов,

Татьяна Николаевна Енькина,

Кристина Блицын,

Игнат Евгеньевич Карпов,

Юлия Владимировна Суворова

Журнал: Кардиология и сердечно-сосудистая хирургия. 2026;19(2):75-85.

DOI: 10.17116/kardio20261902175

Прочитано: 1307 раз

Резюме

АКТУАЛЬНОСТЬ

Седечно-сосудистые заболевания (ССЗ) остаются одной из ведущих причин смерти во всем мире. В последние годы значительное внимание уделяется L-аргинину — условно незаменимой аминокислоте, являющейся ключевым прекурсором оксида азота, критически важного медиатора сосудистой функции. Дисрегуляция метаболизма L-аргинина и развитие эндотелиальной дисфункции играют существенную патогенетическую роль в развитии и прогрессировании ССЗ.

ЦЕЛЬ ИССЛЕДОВАНИЯ

Обзор направлен на систематизацию современных данных о роли L-аргинина в регуляции васкулярного тонуса, его влиянии на эндотелий-зависимую вазодилатацию, а также на оценку потенциала применения L-аргинина в контексте интенсивной терапии сердечно-сосудистых заболеваний.

МАТЕРИАЛ И МЕТОДЫ

Проведен всесторонний анализ результатов экспериментальных исследований in vitro и in vivo, а также клинических испытаний, посвященных изучению влияния L-аргинина на эндотелиальную функцию, гемодинамические показатели, коронарный кровоток и другие параметры сердечно-сосудистой системы. Особое внимание уделено анализу молекулярных механизмов NO-опосредованного действия L-аргинина и его взаимодействию с ферментом аргиназой.

РЕЗУЛЬТАТЫ

L-аргинин способствует усилению эндотелий-зависимой вазодилатации, снижению артериального давления и может оказывать положительное воздействие при ишемической болезни сердца, сердечной недостаточности и атеросклерозе. Важно отметить, что эффективность терапии L-аргинином может модулироваться уровнем ADMA — эндогенного ингибитора NO-синтазы (NOS).

ЗАКЛЮЧЕНИЕ

L-аргинин представляет собой перспективный терапевтический агент для применения в интенсивной терапии седечно-сосудистых заболеваний, особенно у пациентов в ситуации предполагаемого синдрома ишемии-реперфузии. Для определения оптимальных терапевтических стратегий, включающих выбор дозировки и идентификацию целевых групп пациентов, необходимо проведение дальнейших масштабных плацебо-контролируемых клинических исследований.

Ключевые слова

L-аргинин
оксид азота
эндотелиальная дисфункция
сердечно-сосудистые заболевания
аргиназа
асимметричный диметиларгинин (ADMA)

Дата поступления: 10.01.2026

Дата принятия в печать: 30.01.2026

Дата публикации: 08.04.2026

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