国产左旋卡尼汀治疗冠心病心肌缺血的疗效观察  

Therapeutic effect of indigenous L-carnitine in treatment of myocardial ischemia and arrhythmia in patients with coronary heart disease

作　　者：王咏梅[1] 殷仁富[1] 张家友[1] 赵君[1] 吴宗贵[1] 梅长林 顾书华 张纯 

机构地区：[1]第二军医大学长征医院心血管内科,上海200003 [2]长征医院肾内科 [3]常州三维工业技术研究所 [4]长征医院药剂科

出　　处：《第二军医大学学报》2002年第5期548-550,共3页Academic Journal of Second Military Medical University

基　　金：上海市卫生系统百名跨世纪优秀学科带头人培养计划基金 (970 47)

摘　　要：　 目的 :观察国产左旋卡尼汀 (L - carnitine,L - CN)辅助治疗冠心病患者心肌缺血和心律失常的临床疗效。方法 :选择冠心病患者 80例 ,随机分为两组 :对照组 (40例 )常规给予硝酸盐制剂、β受体阻滞剂或钙离子拮抗剂 ;L - CN组 (40例 )在常规治疗的基础上加用国产 L - CN治疗。 结果 :L - CN组与对照组相比 ,可更明显改善冠心病患者胸闷、胸痛和乏力症状 ;对心绞痛缓解的有效率分别为 86 .5 %和 5 7.5 % ,对 ECG缺血性 ST- T改善的有效率分别为 74 .2 %和 4 2 .9% ,均相差显著 (P<0 .0 1) ;治疗心律失常的总有效率分别为 6 7.9%和 35 .5 % (P<0 .0 5 ) ,且未见不良反应。 结论 :常规药物辅以 L - CN是治疗冠心病心肌缺血和心律失常的一种安全有效的新方法 ,可能与改善缺血心肌的能量代谢有关。Objective: To observe the clinical effects of L carnitine in the treatment of myocardial ischemia and arrhythmia of coronary heart disease (CHD). Methods: Eighty cases of CHD patients randomly received routine treatment or L carnitine (3.0 g/d,iv×10 d) with routine therapy. Results: L carnitine effectivly improved a series of symptoms of CHD, such as chest distress ( P <0.05), chest pain ( P <0.05) and hypodynemia ( P <0.005). The effective rates of angina pectoris, ischemic ST T changes and arrhythmia on ECG of L carnitine group were 86.5%, 74.2% and 67.9% ( vs control 57.5%, 42.9% and 35.5%, P <0.05), respectively. No adverse reactions related to the drug were observed. Conclusion: L carnitine with routine therapy might be a safe way to treat myocardial ischemia and the complications caused by it, the mechanism might be related to improvement of energy metabolism of the ischemic myocardium.

关 键 词：左旋卡尼汀 冠心病 心肌缺血 疗效观察 药物疗法 

分 类 号：R972.6[医药卫生—药品] R541.4[医药卫生—药学]