刘卫涛,单金姣,汪磊,曹媛媛,梁世宏,薛玉增

• 1:聊城市人民医院心内科泰山医学院临床学院

摘要(Abstract)：

目的探讨左卡尼汀对急性前壁ST段抬高心肌梗死患者急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后血清超氧化物歧化酶(superoxide dismutase,SOD)及丙二醛(malondialdehyde,MDA)的影响及临床意义。方法连续收集2014年1月至2015年1月因急性前壁ST段抬高心肌梗死行PCI的患者70例,随机分为治疗组和对照组各35例,对照组仅常规治疗,治疗组在对照组治疗的基础上予左卡尼汀每日4 g静脉滴注,连用7 d。分别于就诊即刻和治疗7 d后测定血清中SOD和MDA的含量,并比较两组超声心动图检查结果。结果两组患者治疗7 d后的SOD均显著高于就诊即刻,MDA均显著低于就诊即刻,差异均有统计学意义(均P<0.05)。治疗组治疗7 d后的SOD显著高于对照组,MDA显著低于对照组,差异均有统计学意义(均P<0.05)。治疗7 d后,治疗组的左心室舒张末期内径[(52.80±9.96)mm比(54.75±8.87)mm,P=0.03]、左心室射血分数[(58.50±13.35)%比(55.10±12.97)%,P=0.01]均较对照组有明显改善,差异均有统计学意义。结论左卡尼汀可以升高PCI术后患者血清SOD浓度,减少MDA产生,抑制氧化应激,对心肌具有保护作用。

关键词(KeyWords)： 左卡尼汀;急性心肌梗死;经皮冠状动脉介入治疗;超氧化物歧化酶;丙二醛

Abstract:

Keywords:

基金项目(Foundation): 中国医师协会阳光心血管研究基金项目(SCRFCMDA201302);; 聊城市科学技术攻关项目

作者(Author): 刘卫涛,单金姣,汪磊,曹媛媛,梁世宏,薛玉增

参考文献(References)：

• [1]Piper HM,Garcia-Dorado D.Reducing the impact of myocardial ischemia/reperfusion injury.Cardiovasc Res,2012,94(2):165-167.
• [2]Carvajal K,Moreno-Sanehez R.Heart metabolic disturbances in cardiovascular diseases.Arch Med Res,2003,34(2):89-99.
• [3]中华医学会心血管病分会,中华心血管病杂志编辑委员会.急性心肌梗死诊断治疗指南(2001).中华心血管病杂志,2001,29(12):705-720.
• [4]Piper HM,Garcia-Dorado D.Reducing the impact of myocardial ischemia/reperfusion injury.Cardiovasc Res,2012,94(2):165-167.
• [5]Benhabbouche S,Crola da Silva C,Abrial M,et al.The basis of ischemia-reperfusion and myocardial protectional.Ann Fr Anesth Reanim,2011,30(1):2-16.
• [6]殷宪刚,高晓燕,李瑶.左卡尼汀对急性冠脉综合征患者PCI围术期心肌梗死的预防作用.山东医药,2013,53(15):54-55.
• [7]梁伟钧,孙炎华.急性心肌梗死患者溶栓后内皮损伤与神经肽Y、一氧化氮、超氧化物歧化酶、丙二醛的关系.临床心血管病杂志,2007,23(2):108-110.
• [8]Ribas GS,Vargas CR,Wajner M.L-carnitine supplementation as a potential antioxidant therapy for inherited neurometabolic disorders.Gene,2014,533(2):469-476.
• [9]Cui J,Das DK,Bertelli A,et al.Effects of L-carnitine and its derivatives on postischemic cardiac function,ventricular fibrillation and necrotic and apoptotic cardiomyocyte death in isolated rat hearts.Mol Cell Biochem,2003,254(1-2):227-234.
• [10]Colonna P,Iliceto S.Myocardial infarction and left ventricular remodeling:results of the CEDIM trial.Am Heart J,2000,139(2 Pt 3):S124-S130.
• [11]Ye N,Liu S,Lin Y,et al.Protective effects of intraperitoneal injection of TAT-SOD against focal cerebral ischemia/reperfusion injury in rats.Life Sci,2011,89(23):868-874.
• [12]Amir S,Hartvigsen K,Gonen A,et al.Peptide mimotopes of malondialdehyde epitopes for clinical applications in cardiovascular disease.J Lipid Res,2012,53(7):1316-1326.
• [13]Tarantini G,Scrutinio D,Bruzzi P,et al.Metabolic treatment with L-carnitine in acute anterior ST segment elevation myocardial infarction.A randomized controlled trial.Cardiology,2006,106(4):215-223.