左卡尼汀注射液对冠心病PCI术后患者心肌保护的抗氧化作用研究

目的:探讨左卡尼汀(L-C)对行经皮冠状动脉介入治疗(PCI)术冠心病患者的心肌保护和抗氧化作用。方法:符合入选标准拟行PCI术治疗的非ST段抬高急性冠状动脉综合征(NSTE-ACS)患者40例,按随机表分为对照组(20例)和L-C治疗组(20例),2组患者均在入院后48h内采用股动脉途径,按标准进行PCI。检测术前及术后肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、血清超氧化物岐化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、总抗氧化能力(T-AOC)浓度。结果:PCI术后CK-MB、cTnI水平在2组均有不同程度升高;与对照组相比,L-C治疗组的CK-MB、cTnI水平明显降低(P<0.05)。在2组PCI术后MDA水平均有不同程度升高,L-C治疗组MDA水平显著低于对照组(P<0.01)。2组PCI术后SOD、CAT、GSH-Px、T-AOC水平均有不同程度降低,L-C治疗组的SOD、CAT、GSH-Px、T-AOC水平显著高于对照组(P<0.05)。结论:NSTE-ACS患者PCI术前和术后大剂量(10g·d-1)补充外源性L-C注射液对心肌具有有效地保护作用,其机制与显著提高机体抗氧化酶活性、组织清除氧自由基的能力,减轻心肌细胞受氧自由基攻击的程度有关。

Antioxidation Effects and Cardioprotection Effect of L-carnitine Injection on Patients Undergoing Percutaneous Coronary Intervention

OBJECTIVE：To investigate cardioprotection effect and antioxidation effect of L-carnitine（L-C） on patients undergoing percutaneous coronary intervention（PCI）.METHODS：40 consecutive patients with non-ST-segement elevation NSTE-ACS undergoing PCI were randomized into control group and L-C therapy group（n=20）.Both groups were given PCI within 48 h after hospitalization through femoral artery.The concentration of CK-MB,cTnI,SOD,MDA,GSH-Px,CAT and T-AOC was detected before and after PCI.RESULTS：The level of CK-MB and cTnI in both groups were increased after PCI.As compared with control group,the level of CK-MB and cTnI in L-C therapy group were significantly decreased after PCI（P0.05）.The concentrations of SOD,CAT,GSH-PX and T-AOC in both groups were decreased.The level of SOD,CAT,GSH-PX and T-AOC in L-C therapy group were significantly lower than in control group after PCI（P0.05）.CONCLUSION：L-C injection（10 g·d-1） which are given to NSTE-ACS patients before and after PCI has cardioprotection effect.It also improves the ability of oxygen free radicals clearance and relieve myocardial injury resulted from oxygen radicals.