左卡尼汀对扩张型心肌病患者体内卡尼汀群的代谢影响  

Effect of Levocarnitine on Carnitine Set of Patients with Dilated Cardiomyopathy

作　　者：李盛楠[1,2] 荆凡波[3] 夏蕴秋[1] 郭琳琳[2] 孙振龙 韩志武[3] 隋忠国[3] 王春波[1] 

机构地区：[1]青岛大学医学院药理学教研室,山东青岛266071 [2]青岛大学医学院附属心血管病医院,山东青岛266003 [3]青岛大学医学院附属医院,山东青岛266003 [4]山东省莱阳卫生学校内科教研室,山东烟台265200

出　　处：《中国药房》2013年第4期325-328,共4页China Pharmacy

基　　金：国家科技支撑计划(No.2008BAI54B02)

摘　　要：目的:探讨左卡尼汀注射液在扩张型心肌病(DCM)患者体内的代谢情况。方法:将100例DCM患者随机均分为治疗组和对照组,2组患者均给予常规治疗。治疗组在常规治疗基础上将左卡尼汀注射液2.0g加入0.9%氯化钠注射液20ml中稀释后静脉推注,bid,疗程为14d。采用彩色多普勒超声仪检测治疗前后2组患者的心搏出量(SV)、心输出量(CO)和射血分数(LVEF),并采用柱前高效液相色谱法检测患者体内卡尼汀群的含量。结果:治疗组给药14d后的LVEF为(59.9±5.2)%、CO为(5.9±0.5)L/min、SV为(62.30±4.80)ml/beat,均显著高于对照组同期(P<0.05);给药14d后治疗组的血浆左卡尼汀、乙酰左卡尼汀、丙酰左卡尼汀浓度分别为(146.64±6.71)、(21.40±3.11)、(9.72±2.05)μmol/L,均显著高于对照组同期(P<0.05)。研究中2组均未见明显不良反应发生。结论:左卡尼汀注射液用于扩张型心肌病患者的治疗,能有效改善患者LVEF、CO、SV等心功能指标,并可显著提高患者体内卡尼汀群的血药浓度。OBJECTIVE：To study the metabolize of Levocarnitine（LC）injection on heart function of patients with dilated cardiomyopathy.METHODS：100 cases of dilated cardiomyopathy were randomly divided into treatment group and control group.Both groups were given conventional treatment,and treatment group were additionally given intravenous push of LC injection 2.0 g added into 0.9% sodium chloride 20 ml bid for 14 days.The systolic volume（SV）,cardiac output（CO）and left ventricular ejection fraction（LVEF）were determined by Siemens ACUSON X300 color Doppler before and after treatment,and the content of carnitines was determined by pre-column HPLC.RESULTS：After treatment for 14 days,SV,CO and LVEF were（62.30±4.80）ml/beat,（5.9±0.5）L/min and（59.9±5.2）% in treatment groups,which were higher than control group（P0.05）;after treatment for 14 days,the plasma levels of LC,acetyl-LC and propionyl-LC in treatment group were（146.64±6.71）,（21.40±3.11）and（9.72±2.05）μmol/L,which were all higher than in control group（P0.05）.There was no obvious ADR in 2 groups.CONCLUSION：LC injection can improve the LVEF,CO and SV,and can increase the plasma concentration of LC,ALC and PLC in patients with dilated cardiomyopathy.

关 键 词：左卡尼汀 乙酰左卡尼汀 丙酰左卡尼汀 扩张型心肌病 高效液相色谱 血药浓度 代谢 

分 类 号：R542.2[医药卫生—心血管疾病]