左卡尼汀在急性心肌梗死PCI围手术期的应用效果  

Application of L-carnitine in patients with acute myocardial infarction in perioperative period of PCI

作　　者：郝季春[1] 岳丽霞 王磊 徐超[1] 马东[1] HAO Jichun;YUE Lixia;WANG Lei;XU Chao;MA Dong(Cangzhou Central Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市中心医院,河北沧州061000

出　　处：《中国急救复苏与灾害医学杂志》2023年第11期1401-1403,1408,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：沧州市重点研发项目(编号:204106089)。

摘　　要：目的探讨在急性心肌梗死经皮冠状动脉介入治疗(PCI)围手术期应用左卡尼汀的效果。方法选取河北省沧州市中心医院收治的急性心肌梗死PCI围手术期患者88例,依照随机数字表法分为基础组和治疗组各44例。基础组围手术期采用常规药物治疗。治疗组在常规治疗基础上术中施用左卡尼汀治疗(于入院治疗当日给予3 g/d左卡尼汀,加入生理盐水中静滴,持续至术后2周)。对比治疗前后心肌酶谱、左室超声参数及不良反应。结果治疗前,两组心肌酶谱和左室超声参数差异无统计学意义(P>0.05);治疗后,两组心肌酸激酶同工酶(CK-MB)、磷酸肌酸激酶(CPK)、心肌肌钙蛋白I(CTnI)与左房内径(LAD)均降低,左室射血分数(LVEF)、左心室后壁厚度(LVPWT)与左心室舒张末期室间隔厚度(IVST)均升高,且治疗组CK-MB、CPK、CTnI以及LAD较基础组更低,LVEF、LVPWT、IVST较基础组更高,差异有统计学意义(P<0.05);两组不良反应情况差异无统计学意义(P>0.05)。结论急性心肌梗死PCI围手术期应用左卡尼汀能够改善心肌功能和左室超声参数,且不会增加患者不良反应。Objective To explore the effect of L-carnitine in patients with acute myocardial infarction during perioperative period of percutaneous coronary intervention(PCI).Methods A total of 88 patients with acute myocardial infarction during perioperative PCI admitted to Cangzhou Central Hospital in Hebei Province were randomly divided into the control group and the treatment group.The control group was treated with conventional drugs,while the treatment group was treated with L-carnitine on the basis of conventional treatment(3 g/d L-carnitine was given on the day of admission for treatment,and intravenous infusion was continued to 2 weeks after surgery).The myocardial zymogram,left ventricular ultrasound parameters before and after treatment and adverse reactions were compared.Results There was no significant difference in the myocardial zymogram and left ventricular ultrasound parameters before treatment in both groups(P>0.05).In the two groups creatine kinase isoenzyme(CK-MB),phosphocreatine kinase(CPK),cardiac troponin I(CTnI)and left atrial diameter(LAD)were lower than those before treatment,left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT)and left ventricular end-diastolic chamber Interval thickness(IVST)were higher than those before treatment,moreover,CK-MB,CPK,CTnI and LAD of treatment group were lower than those of control group,the LVEF,LVPWT and IVST of treatment group were higher than those of control group,with statistical differences(P<0.05).There was no significant difference in adverse reactions(P>0.05).Conclusion Lcarnitine can improve myocardial function and left ventricular remodeling,without increasing adverse reaction in patients with acute myocardial infarction during perioperative PCI.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 左卡尼汀 心功能 

分 类 号：R543.31[医药卫生—心血管疾病]