左卡尼汀对心肌梗死患者PTCA术后心肌活性的影响  

The effect of L-carnitine on myocardial viability of patients with myocardial infarction after PTCA

作　　者：刘晓红[1] 张锦[1] 来春林[1] 贺业新[2] 

机构地区：[1]山西省人民医院心内科,太原030012 [2]山西省人民医院心内科核磁室

出　　处：《中国循证心血管医学杂志》2013年第3期249-251,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：山西省卫生厅科技攻关项目(20100205)

摘　　要：目的研究左卡尼汀对心肌梗死患者经皮腔内冠状动脉成形术(PTCA)前后心肌活性的作用。方法将心肌梗死后行PTCA的患者40例随机分为两组,一组为对照组(常规治疗,n=20),另一组为左卡尼汀组(常规治疗+左卡尼汀,n=20)。所有患者在PTCA治疗前及治疗6个月后采用磁共振灌注及延迟成像扫描评价透壁率;同时检测血清基质金属蛋白酶9(MMP-9)、超敏C反应蛋白(hs-CRP),观察其在治疗前后的变化。结果两组患者治疗后左室射血分数(LVEF)较治疗前均有明显改善,对照组(51.2±14.5)%vs.(42.6±15.2)%,左卡尼汀组(55.7±15.1)%vs.(43.1±16.7)%](P<0.05),以左卡尼汀组LVEF改善更加显著(P<0.05)。40例患者首过期心肌灌注改善33例,占82.5%。延迟期心肌增强面积减少38例,占95%。两组患者治疗6个月后血清MMP-9、hs-CRP水平均低于治疗前(P<0.01),以左卡尼汀组降低更为明显(P<0.05)。结论左卡尼汀可改善心肌能量供应,进而改善心肌细胞功能。Objective To study the the curative effect of L-carnitine on the patients with myocardial infarction after percutaneous transluminal coronary angioplasty （PTCA）. Methods The patients with myocardial infarction who took the PTCA（n=40） were randomly divided into control group （with routine treatment, n=20） and L-carnitine group （with routine treatment and L-carnitine, n=20）. Before and 6 months after PTCA, the results of De-MRI were reviewed and transmural rate was analyzed. The changes of matrix metalloproteinase-9 （MMP-9） and high sensitivity C-reactive protein （hs-CRP） were observed at the same time. Results After PTCA, the left ventricular ejection fraction （LVEF） was significantly improved in two groups, （51.2 ± 14.5）% vs. （42.6 ± 15.2）% in control group, and （55.7± 15.1）% vs. （43.1 ± 16.7）% in L-carnitine group （P〈0.05）, which was more significant in L-carnitine group （P〈0.05）. In 40 patients, myocardial perfusion was relieved in 33 （82.5%） at first-pass period, and enhanced myocardial area was decreased in 38 （95%）. After 6 months, the levels of MMP-9 and hs-CRP were lower than before the treatment （P〈0.01）, which was more significant in L-carnitine group （P〈0.05）. Conclusion L-carnitine could improve the energy supplies of cardiomyocytes and so the functions.

关 键 词：心肌梗死 磁共振 心肌活性 左卡尼汀 致动脉粥样硬化因子 

分 类 号：R542.22[医药卫生—心血管疾病]