左卡尼汀注射液预防纵隔肿瘤患者急性放射性心脏损伤的临床观察

目的：观察左卡尼汀注射液预防纵隔肿瘤患者急性放射性心脏损伤的临床效果。方法选取纵隔肿瘤患者104例，随机双盲将纳入患者分为观察组和对照组各52例，分组方法采用CONSORT声明（2010版）标准。对两组患者均给予放射治疗，观察组另外给予左卡尼汀注射液。观察两组患者治疗过程中出现的心脏炎症反应情况、心电图异常情况并检测患者治疗前后血清乳酸脱氢酶（LDH）、肌酸激酶（CK）、肿瘤坏死因子（TNF-α）和转化生长因子-β（TGF-β）含量。结果治疗过程中观察组炎症发生率为28.85%，低于对照组的53.85%（P﹤0.05）；治疗后观察组心电图异常患者比率为38.46%，低于对照组的65.38%（P﹤0.05）；治疗后观察组总不良反应发生率为32.69%，低于对照组的59.62%（P﹤0.05）；治疗后观察组CK和LDH水平均低于对照组，且差异有统计学意义（P﹤0.05）；治疗后观察组患者体内TNF-α和TGF-β含量低于对照组，差异有统计学意义（P﹤0.05）。结论纵隔肿瘤患者放射治疗的过程中加用左卡尼汀注射液可有效降低患者心肌炎症反应，维持心脏功能的稳定。

Clinical effect of L-carnitine injection on the acute radiation induced heart injury in patients with mediastinal tumors

Objective To observe the preventive effect of L-carnitine injection on the acute radiation induced heart in-jury in patients with mediastinal tumor. Method 104 patients diagnosed with mediastinal tumor were included in the study, and were randomized as study group and control group according to CONSORT statement (2010), with 52 cases in each. Radiotherapy was given to both groups, while the study group was additionally administered with L-carnitine injec-tion. Cardiac inflammatory responses and abnormal ECG during treatment cycles were observed, and the serum lactate de-hydrogenase (LDH) and creatine kinase (CK) levels before and after treatment were recorded. Result The incidence of inflammation in study group was 28.85%, significantly lower than that of the control group at 53.85%(P<0.05);The pro-portion of patients with abnormal ECG after treatment in study group and control group was 38.46%and 65.38%, with significant difference observed (P<0.05);The adverse reactions occurred in 32.69%of the patients in study group, signifi-cantly lower than that of the control group at 59.62%(P<0.05);And the CK and LDH levels in study group were lower, and yet the TNF-ɑand TGF-βlevels were also lower in study group than those of the control group (P<0.05). Conclusion L-carnitine injection can effectively reduce the radiation induced inflammatory response, maintaining the stability of car-diac function.