左旋卡尼丁对急性心肌梗死患者肌钙蛋白T和C-反应蛋白的影响及意义

Effect of L-carnitine on cardiac troponin T and C-reactive protein in patients with acute myocardial infarction

目的探讨左旋卡尼丁（L—CN）对急性心肌梗死患者肌钙蛋白T（cTnT）和C-反应蛋白（CRP）含量的影响。方法2004年1～12月在沈阳医学院附属沈洲医院住院治疗的急性心肌梗死（AMI）患者25例，为试验组，给予L-CN4．0g／d，共用7d；另选AMI患者25例作为对照组。所有患者于用药前、用药第3天后，用药结束后检测cTnT和CRP。并于用药前和用药结束后行超声心动图检查及心肌灌注显像分析。结果用药前cTnT和CRP含量两组间差异无显著性意义（P〉0．05）。用药第3天后试验组cTnT和CRP较对照组下降但差异无显著性意义；用药结束后试验组cTnT和CRP较对照组显著减低（P〈0．05）。试验组在用药后左心室射血分数（LVEF）较对照组明显改善（P〈0．05），心肌缺损面积缩小（P〈0．05）。结论心肌梗死时给予L-CN治疗可降低血循环中cTnT和CRP含量，有利于心肌修复，缩小梗死面积。

Objective To investigate the effect of L-carnitine（L-CN） on cardiac troponin T（cTnT） and C-reactive protein（CRP） in patients with acute myocardial infarction（AMI）. Methods A total of 25 patients suffering from AMI （trial group） were given L-CN 4.0 g/d,totally 7 days,and control group were given placebo. CTnT and CRP were analyzed at baseline ,given L-CN dieb tert and run-out L-CN in all patients. Echocardiography and ^99Tc-MIBI myocardial imaging were performed. Results There was no difference between two groups at baseline （ P 〉 0. 05） ; the levels of CTnT and CRP of trial group were lower than control group when given L-CN dieb tert（ P 〉 0. 05 ）, but significantly lower than control group when run-out L-CN （ P 〈 0. 05）. LVEF of trial group was significantly higer than control group （/5 〈 0.05 ）, and defect size decreased （P 〈 0. 05）. Conclusion The levels of CTnT and CRP in patients with AMI depress if given L-CN.