左卡尼汀辅助治疗急性缺血性脑卒中静脉溶栓54例  

Effect of Levocarnitine Assisted in the Intravenous Thrombolytic Therapy for 54 Patients with Acute Ischemic Stroke

作　　者：檀立端[1] 高君武 耿永芝 陈治国[1] TAN Liduan;GAO Junwu;GENG Yongzhi;CHEN Zhiguo(Department of Emergency,Chengde Central Hosptial,Chengde,Hebei Province,067000 China)

机构地区：[1]河北省承德市中心医院急诊科

出　　处：《医药导报》2019年第12期1608-1611,共4页Herald of Medicine

基　　金：承德市科学技术研究与发展计划项目(201706A030)

摘　　要：目的探讨左卡尼汀对急性缺血性脑卒中静脉溶栓患者血清心型脂肪酸结合蛋白(H-FABP)水平及脑功能的影响。方法选取2015年1月-2018年1月于河北省承德市中心医院急诊科就诊并收治入院的96例静脉溶栓的急性缺血性脑卒中患者为研究对象,采取随机数字表法将患者分为治疗组和对照组,治疗组54例,对照组42例。对照组患者在静脉溶栓治疗基础上接受阿托伐他汀等常规药物治疗,治疗组患者在对照组基础上接受左卡尼汀治疗,每天1次,每次3 g,治疗2周,监测治疗前、治疗后12,48和72 h血清H-FABP变化水平,记录治疗前、治疗后1,7,90 d的NIHSS评分和BI评分。结果治疗组和对照组患者治疗前血清H-FABP水平差异无统计学意义(P>0.05),两组患者血清H-FABP水平均下降,应用左卡尼汀治疗后各时间点组患者血清H-FABP水平均低于对照组患者,差异有统计学意义(P<0.05);两组患者治疗前NIHSS评分和BI评分比较差异无统计学意义(P>0.05),治疗组治疗后不同时间点NIHSS评分较对照组低,BI评分高于对照组,差异有统计学意义(P<0.05)。结论左卡尼汀可降低急性缺血性脑卒中静脉溶栓患者血清H-FABP水平表达,挽救濒临死亡的神经元细胞,促进脑功能的恢复。Objective To investigate the effect of levocarnitine on the level of serum heart-type fatty acid binding protein(H-FABP) and brain function in patients with acute ischemic stroke after an intravenous thrombolytic therapy. Methods Ninety-six patients with acute ischemic stroke treated by intravenous thrombolytic therapy from January 2015 to January 2018 in the emergency department of Chengde Central Hospital of Hebei Province were enrolled as the study subjects.Patients were divided into the treatment group(54 cases) and the control group(42 cases) by a random number table method.Patients in the control group were treated with conventional drugs such as atorvastatin after the intravenous thrombolysis, while patients in the treatment group were treated with additional dose of levocarnitine once a day, 3 g each time, for 2 weeks on the basis of therapy in the control group.Serum H-FABP levels were monitored before treatment, and after treatment at 12, 48 and 72 h, and NIHSS scores and BI scores were recorded before treatment and 1, 7 and 90 d after treatment. Results The serum H-FABP levels had no statistical difference before treatment in both groups.The serum H-FABP levels of the treatment group were significantly lower than those in the control group after treatment at 12, 24 and 48 h(P<0.05). The NIHSS scores were significantly lower than those in the control group after treatment at 1, 7 and 90 d(P<0.05).Barthel index scores were significantly higher than those in the control group after treatment at 1, 7 and 90 d(P<0.05). Conclusion Levocarnitine could effectively reduce the serum H-FABP levels, prevent neurons from dying, and promote the recovery of brain function.

关 键 词：左卡尼汀 缺血脑卒中 急性 静脉溶栓 脂肪酸结合蛋白 心型 脑功能 

分 类 号：R973.2[医药卫生—药品] R543[医药卫生—药学]