左卡尼汀对心内直视术患者心肾缺血再灌注损伤的影响  

Effect of Levocarnitine on Cardiac and Renal Ischemia-reperfusion Injury in Patients Undergoing Open-heart Surgery

作　　者：方梅荣 肖友文[1] 李灿[2] 

机构地区：[1]乐山市人民医院肾内科,四川乐山614000 [2]延边大学附属医院肾内科,吉林延边133002

出　　处：《解放军医药杂志》2016年第12期87-90,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金资助项目(81160092)

摘　　要：目的分析左卡尼汀对心内直视术患者心肾缺血再灌注损伤的影响。方法收集2011年2月—2015年1月接受体外循环心脏瓣膜置换术治疗的76例患者的临床资料,其中35例给予常规扩张冠状动脉、抗凝及降脂干预,作为对照组,41例在常规治疗基础上加用左卡尼汀,作为观察组。比较手术前后两组血肌酐(Cr)、尿素氮(BUN)、尿微量白蛋白(UAE)、β2-微球蛋白(β2-MG)、超氧化物歧化酶(SOD)、丙二醛(MDA)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)等指标的变化,记录手术前后两组心脏指数(CI)和左心室射血分数(LVEF)的变化。结果两组术后CK、CK-MB、CI、LVEF、BUN、Cr、UAE、β2-MG和MDA均较术前上升,但SOD较术前降低(P<0.05)。术后观察组CK、CK-MB、BUN、Cr、UAE、β2-MG和MDA均低于对照组(P<0.05);而CI、LVEF和SOD均高于对照组(P<0.05)。两组均未出现不良反应。结论左卡尼汀可减轻心内直视术患者心、肾等组织缺血再灌注损伤,降低氧化应激反应,保护心、肾功能。Objective To analyze effect of Levocarnitine on cardiac and renal ischemia-reperfusion injury in patients undergoing open-heart surgery. Methods Clinical data of 76 patients who received cardiopulmonary bypass heart valve replacement between February 2011 and January 2015 was collected. Among them,35 patients（ control group） received of routine treatments such as coronary dilatation,anticoagulation and interventions of reduction blood fat,while 41patients（ observation group） were added with Levocarnitine on the basis of routine treatment. Changes of indexes such as serum creatinine（ Cr）,blood urea nitrogen（ BUN）,microalbuminuria（ UAE）,beta2-microglobulin（ β2-MG2）,superoxide dismutase（ SOD）,malondialdehyde（ MDA）,creatine kinase（ CK）,creatine kinase isoenzyme（ CK-MB） were compared between the two groups before and after operation. Changes of cardiac index（ CI） and left ventricular ejection fraction（ LVEF） were recorded before and after operation in two groups. Results Values of CK,CK-MB,CI,LVEF,BUN,Cr,UAE,β2-MG and MDA were increased,while SOD value was lower after operation compared with those before operation in the two groups（ P〈0. 05）. After operation in observation group,values of CK,CK-MB,BUN,Cr,UAE,β2-MG and MDA were lower（ P〈0. 05）,while values of CI,LVEF and SOD were higher than those in the control group（ P〈0. 05）. No adverse reactions were found in the two groups. Conclusion Levocarnitine can relieve cardiac and renal ischemia-reperfusion injury,reduce oxidative stress reactions and protect cardiac and renal function for patients undergoing open-heart surgery.

关 键 词：左卡尼汀 体外循环 心内直视术 再灌注损伤 

分 类 号：R619.9[医药卫生—外科学]