左旋卡尼汀防治心肌缺血老年患者围术期心肌梗死的效果观察  

Efficacy of L-carnitine in preventing myocardial infraction of elderly patients with myocardial ischemia during surgery

作　　者：付伟东[1] 潘晓霞[1] 雷李培[1] 

机构地区：[1]丽水市中心医院暨温州医学院附属第五医院麻醉科,浙江丽水323000

出　　处：《中国医院药学杂志》2008年第17期1482-1484,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:研究在围术期应用左旋卡尼汀对心肌缺血老年患者心肌梗死的预防和治疗作用。方法:40例有心肌缺血基础的老年患者随机分为治疗组和对照组,每组各20例。治疗组在麻醉诱导前30min以左旋卡尼汀3.0g加入0.9氯化钠注射液250mL持续静滴;对照组静脉滴注0.9氯化钠注射液。术中纪录心电图各导联(II、III、V、aVF)ST段水平、MAP、HR,并计算HR和SBP的乘积(RPP),同时抽取外周静脉血检测术前、术毕、术后24h血清心肌肌钙蛋白Ⅰ(cTnⅠ)水平。结果:术中对照组出现明显的ST段下降和RPP升高,与治疗组比较差异有显著性(P<0.05);治疗组术后cTnⅠ水平的升高程度较对照组为低,两组间差异有显著性(P<0.05)。术后对照组有2例出现灶性心肌梗死。结论:左旋卡尼汀预防和治疗老年患者围术期心肌缺血、心肌梗死具有较好的作用。OBJECTIVE To evaluate L-carnitine in preventing and treating acute myocardial iniarction（AMI） m elderly patients with myocardial ischemia during surgery. METHODS The 40 patients undergoing abdominal surgery were randomly divided into two equal groups： L group（treated with L carnitine） and C group（without L-carnitine）. All patients surffered from myocardial ischemia preoperatively,or showing ST segment depression. The L-group administered 3.0 g of L-carnitine iv 30 min before induction, The level of ST-segment, the blood pressure and heart rate（HR） were recorded, and rate-pressure（RPP） was counted. Blood from peripheral vein was withdrawn at three points（before operation, after operation and 24h after opteration） for cardiac troponin Ⅰ（cTn Ⅰ） marker. RESULTS More ST-segment depression and RPP elevation were observed in C- group, which was different significantly from L-group （P〈0. 05）. Serum cTn I marler elevated in C-group more obvious than in L-group （P〈0.05）. There were tow cases in C-group suffering from local AMI postoperatively. But there was no statistical difference between tow groups. CONCLUSION L-carnitine may be of value in preventing and treatment in elderly patients durmg surgery.

关 键 词：左旋卡尼汀 老年患者 心肌梗死 围术期 

分 类 号：R972[医药卫生—药品]