左卡尼汀对体外循环下冠状动脉旁路移植术患者hs-CRP和同型半胱氨酸水平的影响

目的评价围手术期静滴左卡尼汀对体外循环下冠状动脉旁路移植术(coronary artery bypass grafting,GABG)患者血清高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)和同型半胱氨酸(homocysteine,HCY)水平的影响。方法选择在我科接受体外循环下GABG治疗的62例冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAD)患者,按随机数表法均分为两组,各31例。观察组在围手术期静脉滴注左卡尼汀,对照组静滴等量生理盐水。两组患者均于术前1 h,主动脉开放后2 h,6 h,24 h和48 h采静脉血,检测其血清hs-CRP和HCY水平。结果术前及主动脉开放后2 h,两组患者血清hs-CRP水平的差异均无统计学意义(均P> 0.05);且术前两组间血清HCY水平的差异也无统计学意义(P>0.05);主动脉开放后6 h,24 h和48 h时,观察组血清hs-CRP水平较对照组显著降低,且差异均有统计学意义(均P <0.001);主动脉开放后2 h,6 h,24 h和48 h,观察组血清HCY水平也较对照组显著降低,且差异也均有统计学意义(均P <0.01)。且各组血清hs-CRP水平和HCY水平在不同时间点的差异也均有统计学意义(均P <0.001);两组患者术前血清hs-CRP和HCY水平均较低,但在主动脉开放后其血清hs-CRP水平和HCY水平逐渐升高,且血清hs-CRP水平和HCY水平分别于主动脉开放48及24 h时达其峰值(均P <0.001)。结论对体外循环下行GABG的患者围手术期予以左卡尼汀静滴,可明显降低其血清hs-CRP和HCY水平,这可能与其具有心肌保护作用有关。

Effects of L-carnitine on serum high-sensitivity C-reactive protein and homocysteine in patients undergoing coronary artery bypass grafting

LI Ming;LIU Jun-hui;YAN Yang;WANG Hai-chen;LI Yong-xin;YI Qiu-yue;WANG Rui-li;LI Wen;XUE Li(Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China;Department of Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China;Department of Geriatrics Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China;Department of Laboratory, The Second Affiliated Hospital of Xi'an Jiaotong University、Xi'an 710004, China)