实用医学杂志 ›› 2022, Vol. 38 ›› Issue (8): 942-946.doi: 10.3969/j.issn.1006⁃5725.2022.08.006

• 专题报道 • 上一篇    下一篇

左卡尼汀对急性ST段抬高型心肌梗死经皮冠状动脉介入治疗术后的心肌保护作用

曹莉芳 赵闯   

  1. 开封市人民医院心内科(河南开封 475000)

  • 出版日期:2022-04-25 发布日期:2022-06-08

The myocardial protective role of L ⁃ carnitine in acute ST segment elevation myocardial infarction after PCI

CAO Lifang,ZHAO Chuang.   

  1. Department of CardiologyKaifeng People′s HospitalKaifeng 475000China
  • Online:2022-04-25 Published:2022-06-08

摘要:

目的 探讨左卡尼汀对急性 ST 段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术 后心肌保护作用。方法 选取 2018 年 3 月至 2019 年 3 月医院收治的 96 例 PCI 术后 STEMI 患者,采用随机 数表分为对照组(48例)给予常规的预后改善治疗(抗凝、血脂调节等),持续14 d;研究组(48例)以此为基 础,另施以左卡尼汀治疗,持续 14 d。对比两组患者治疗前后心肌肌钙蛋白 I(cTnI)、血清肌酸激酶同工酶 (CK⁃MB)、血清超氧化物歧化酶(SOD)含量、总抗氧化能力(T⁃AOC),左室射血分数(LVEF)、6 min 步行距 离及术后 3 个月内的主要心血管不良事件(MACE)。结果 治疗前两组患者 cTnI、CK⁃MB、SOD、T⁃AOC 含 量、LVEF 值和6 min 步行距离差异无统计学意义(> 0.05),治疗后两组患者cTnI、CK⁃MB 含量均降低(< 0.05),且研究组cTnI 含量低于对照组(< 0.05),CK⁃MB 含量两组相近(> 0.05),SOD、T⁃AOC 含量、LVEF 值和 6 min步行距离均升高(< 0.05),且研究组均高于对照组(< 0.05);研究组术后3个月内患者MACE 总发生率低于对照组(< 0.05)。结论 左卡尼汀能够减少 STEMI 患者 PCI 术后 cTnI、CK⁃MB 含量,增加 SOD、T⁃AOC 含量,修复受损心肌,改善心功能,降低MACE 的发生率。

关键词:

左卡尼汀, 急性ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 心肌保护

Abstract:

Objective To investigate the myocardial protective effect of L⁃carnitine in acute ST⁃segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI). Methods 96 patients with STEMI after PCI who had been treated during the period of March 2018 to March 2019 were selected. They were randomly assigned to receive either routine prognostic improvement therapies with anticoagulation and lipid regulation(basic group,48 patients),or the routine therapies plus levocarnitine(study group,48 patients)for 14 days. Cardiac troponin I(cTnI),creatine kinase isoenzyme(CK⁃MB),serum superoxide dismutase(SOD), total antioxidant capacity(T ⁃AOC),left ventricular ejection fraction(LVEF),and 6 ⁃ minute walking distance were compared between the two groups before and after treatment,so was the major adverse cardiovascular events (MACE)within 3 months after PCI between the two groups. Results There were no significant differences in cTnI CK ⁃MB,SOD,T ⁃AOC,LVEF value,and 6⁃minute walking distance between the two groups before treatment (P > 0.05). After treatment,the contents of cTnI and CK ⁃MB declined in both groups,and the content of cTnI was lower in the study group than in the basic group(P < 0.05),while that of CK⁃MB was similar(P > 0.05);the contents of SOD,T ⁃AOC,LVEF and 6min walking distance increased and they were higher in the study group than in the basic group(P < 0.05). The total incidence of MACE within 3 months after PCI was lower in the study group than in the basic group(P < 0.05). Conclusions Levocarnitine can reduce the contents of cTnI and CK⁃MB increase the contents of SOD and T ⁃AOC,improve myocardial damage,increase the LVEF value and 6⁃minute walking distance,and lower the incidence of MACE in STEMI patients after PCI.

Key words:

L?carnitine, ST?segment elevation myocardial infarction, percutaneous coronary interven? tion, myocardial protection