摘要
目的探究不同剂量左卡尼汀(L-CN)注射液对非ST段抬高型急性冠脉综合征(NSTE-ACS)患者经皮冠脉介入(PCI)治疗后的心肌保护作用及卡尼汀群在患者体内的代谢变化。方法选择符合纳入标准并均在入院后第3天行PCI治疗的NSTE-ACS患者120例,随机分为四组:对照组及不同剂量L-CN治疗组,每组30例。所有患者给予常规治疗,L-CN治疗各组在常规治疗基础上分别给予2、4及6 g/d L-CN连续静脉输注7 d。比较各组术前、术后肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、血清超氧化物岐化酶(SOD)、丙二醛(MDA)、高敏C-反应蛋白(hs-CRP)的浓度变化,并采用高效液相色谱法(HPLC)检测患者体内卡尼汀群的代谢变化。结果术后各组血浆CK-MB、cTnI、hs-CRP、MDA水平均有不同程度升高,治疗各组血浆CK-MB、cTnI、hs-CRP、MDA水平在术后相同时间点均明显低于对照组(P<0.05或P<0.01)。术后各组SOD水平均有不同程度降低,治疗组SOD水平显著高于同期对照组(P<0.05或P<0.01)。6 g/d L-CN治疗组各指标水平均明显优于另外两治疗组(P<0.05或P<0.01)。治疗7 d后,治疗组血浆L-CN、ALC、PLC浓度均显著高于治疗前及对照组同期水平(P<0.01)。治疗前各组血浆L-CN浓度与cTnI水平呈正相关(r=0.8055,P<0.01)。结论不同剂量L-CN注射液用于NSTE-ACS患者PCI术后的治疗,可提高患者体内卡尼汀群的血药浓度,明显改善CK-MB、cTnI、hs-CRP、MDA、SOD等临床指标,对患者心肌具有有效的保护作用,尤以6 g/d L-CN疗效最佳。
Objective To explore the myocardial protection of different doses of L-carnitine （L-CN） injection in patients with non-ST-elevation acute coronary syndrome （NSTE-ACS） undergoing percutaneous coronary intervention （PCI） and the metabolism of carnitines in patients＇ body. Methods According to the inclusion criteria, 120 patients with NSTE-ACS undergoing PCI in the third day after hospitalization were selected, and they were randomly divided into control group and different doses of L-CN therapy groups, with 30 cases in each group. All the patients were given conventional therapy and each therapy group was additionally given intravenous infusion of 2, 4, 6 g/d L-CN for 7 days. The concentration of CK-MB, eTnI, hs-CRP, MDA and SOD were detected before and after PCI, and the metabolic changes of carnitines was measured by high performance liquid chromatography （HPLC）. Results The levels of CK-MB, cTnI, hs-CRP and MDA in each group after PCI increased, and the levels of those indexes in the therapy groups were significantly lower than those in the control group （P〈0.05 or P〈0.01）. The levels of SOD in each group after PCI decreased, and those in the therapy groups were significantly higher than those in the control group （P〈0.05 or P〈0.01）. The levels of each clinical indexs in 6 g/d L-CN therapy group were obviously superior to those in the other two therapy groups （P〈0.05 or P〈0.01）. The levels of L-CN, ALC and PLC in therapy groups were obviously higher than those before treatment and those in the control group after 7 days of the treatment （P〈0.01）. There was a positive correlation between the concentration of L-CN and cTnI in each group before treatment （r=0.8055, P〈0.01）. Conclusion Different doses of L-CN injection which are given to NSTE-ACS patients undergoing PCI can increase the concentration of carnitines and evidently improve the level of CK-MB, cTnI, hs-CRP, MDA, SOD, especially 6 g/d L-CN therapy is more effective.
出处
《临床医学研究与实践》
2017年第27期6-8,11,共4页
Clinical Research and Practice
