左-卡尼汀对急性脑梗死患者血浆基质金属蛋白酶的影响  

THE EFFECT OF LEVOCARNITINE FOR PLASMATIC MATRIX METALLOPROTEINASES(MMPS) ON ACUTE CEREBRAL INFARCT PATIENTS

作　　者：蔡鸿[1] 易韦[1] 李玫[1] 瞿浩[1] 

机构地区：[1]贵州省人民医院,贵阳550002

出　　处：《现代预防医学》2010年第12期2353-2354,2356,共3页Modern Preventive Medicine

基　　金：贵州省自然科学基金资助项目(黔科通[2003]50号)

摘　　要：[目的]观察急性脑梗死患者,静脉滴注不同剂量的左-卡尼汀对血浆基质金属蛋白酶（MMPs）的影响。[方法]157例起病6-24h的急性脑梗死患者按入院时间序贯分为3组,治疗1组每日静脉滴注左-卡尼汀6g,连续14d;治疗2组每日静脉滴注左-卡尼汀3g,连续14d;对照组除不用左-卡尼汀外,其他治疗条件同前两组;入院时和入院后14d,对所有患者进行神经功能缺损评分（用斯堪的那维亚卒中量表）和意识障碍评分（用Glasgow-Pittsburgh量表）。[结果]①治疗1组患者血浆MMP-2在入院后3d到14d明显低于对照组（P﹤0.05）,其中在入院后3d明显低于治疗2组（P﹤0.05）;治疗1组患者血浆MMP-9从入院后3d到14d明显低于对照组和治疗2组（P﹤0.05）。②两组治疗14d后神经功能缺损评分和意识障碍评分差异无统计学意义（P﹥0.05）。[结论]左-卡尼汀可能通过降低脑缺血后血浆基质金属蛋白酶水平,对急性脑梗死患者有潜在的较好的神经保护作用。[Objective] To investigate the effect of levocarnitine for plasmatic matrix metalloproteinases（MMPs） on acute cerebral infarct patients,and analyze the possible mechanism of action of levocarnitine in preventing and treating cerebral infarct disease.[Methods] 157 cases with acute cerebral infarct were randomly allocated into three groups：test group 1（n = 53）,6 g /d L-carnitine was administered for intravenous drip and test group 2（n = 52）,3g /d L-carnitine was administered for intravenous drip.The treatment for both groups was a fourteen-day course of one dose per day;The control group（n = 52） got the same treatment with the L-carnitine group except 5% glucose-normal saline was administered instead of L-carnitine.The Scale of Clinical Neurological Deficit（scandinavian stroke scale,SSS） and Judgment Criterions of Conscious Disturbance（Glasgow-Pittsburgh coma scale,G-Pcs） were assessed on the first day and the 14th day in the hospital,respectively.[Results] ① Since the third to 14 days in hospital,the plasmatic level of MMP-2 in test group 1 were significant lower than that in the control group（P﹤0.05）,especially significant lower than that in test group 2 on the third day in hospital（P﹤ 0.05）;② From the third to 14th days in hospital,the plasmatic level of MMP-9 in test group 1 were significant lower than that in test group 2 and the control group（P ﹤ 0.05） ;③ The Scale of Clinical Neurological Deficit and Judgment Criterions of Conscious Disturbance had no significant among the three groups（P ﹥ 0.05）.[Conclusion] The results demonstrated that levocarnitine has a potent neuroprotective effect for acute cerebral infarct disease,and it may reduce the plasmatic level of MMPs and decrease the injury by cerebral ischemia.

关 键 词：脑梗死 急性 左-卡尼汀 基质金属蛋白酶 神经保护 

分 类 号：R743.33[医药卫生—神经病学与精神病学]