左卡尼汀对冠心病PCI术心肌缺血再灌注损伤的保护作用  

Cardioprotection effect on myocardial ischemia reperfusion injury of L-Carnitine in patients undergoing percutaneous coronary intervention

作　　者：陈汉想[1] 李琦[1] 周威[1] 彭超华[1] CHEN Han-xiang;LI Qi;ZHOU Wei;PENG Chao-hua(College of Health Science&Nursing of Wuhan Polytechnic University in Hubei Province,Wuhan 430023,China)

机构地区：[1]武汉轻工大学医护学院,湖北武汉430023

出　　处：《中国当代医药》2018年第8期13-16,20,共5页China Modern Medicine

基　　金：湖北省自然科学基金项目(2015CFC843)

摘　　要：目的探讨左卡尼汀对冠心病PCI术患者心肌缺血再灌注损伤的保护作用。方法选取我院2014年4月~2016年12月符合标准拟行PCI治疗的60例冠心病患者,按随机数字表法分为治疗组和对照组,各30例。对照组行PCI治疗并口服拜阿司匹林片(100 mg,1次/d)、氯吡格雷片(75 mg,1次/d)、阿托伐他汀钙片(20 mg,每晚口服)、美托洛尔缓释片(23.75~47.50 mg,1次/d)、单硝酸异山梨醇酯缓释片(40 mg,2次/d)。治疗组在对照组治疗基础上术前加用左卡尼汀2.0 g静脉滴注,术后1次/d,连续7 d。检测两组术前及术后的肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、C反应蛋白(CRP)、脑钠肽(BNP)、血浆游离脂肪酸含量(FFA)和左室射血分数(LVEF)。结果两组患者术后的LVEF指标均高于同组术前,差异有统计学意义(P<0.05);治疗组术后的CK-MB、cTnI、CRP、BNP、FFA水平均低于对照组,LVEF指标高于对照组,差异有统计学意义(P<0.05)。结论左卡尼汀对冠心病行PCI患者的心肌缺血再灌注损伤具有保护作用,能改善心肌能量代谢和心脏功能。Objective To investigate cardioprotection effect on myocardial ischemia reperfusion injury of L-Carnitine(L-C)in patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods Sixty patients with CHD undergoing PCI from April 2014 to December 2016 in our hospital were selected and divided into the treatment group and the control group through a random number table method,30 cases in each group.The control group was treated with PCI and oral Aspirin(100 mg,1 time/d),Clopidogrel(75 mg,1 time/d),Atorvastatin Calcium Tablet(20 mg,every night),Metoprolol Zyban(23.75-47.50 mg,1 time/d),Single Isosorbide Nitrate Ester Zyban(40 mg,2 times/d).The treatment group was injected with the L-Carnitine 2.0 g intravenous drip before operation on the basis of the control group and continued once a day for 7 days after surgery.The concentration of CK-MB,cTnI,CRP,BNP,FFA and LVEF before and after PCI were compared between the two groups.Results LVEF in the two groups after operation were higher than those before PCI,with significant diference(P<0.05).The indexes of CK-MB,cTnI,CRP,BNP and FFA after PCI in the treatment group were lower than those in the control group,and LVEF was higher than that of the control group,with significant diference(P<0.05).Conclusion L-Carnitine has cardioprotection effect on myocardial ischemia reperfusion injury in patients with CHD undergoing PCI.It can improve myocardial energy metabolism and cardiac function.

关 键 词：左卡尼汀 心肌缺血再灌注损伤 经皮冠状动脉内支架植入术 心肌保护 

分 类 号：R541.4[医药卫生—心血管疾病]