左旋卡尼汀改善冠状动脉旁路移植术患者预后的临床实验研究

The Effect of Propionyl L-carnitine on Patients Operated for Coronary Artery Bypass Grafting

目的探讨左旋卡尼汀是否能够改善接受冠状动脉旁路移植术患者的近期预后。方法2006年5月至2009年5月在我院接受冠状动脉旁路移植术的60例患者,其中实验组30例,对照组30例。实验组术前3d开始用左旋卡尼汀静脉滴注预处理,对照组用0.9%氯化钠溶液静脉滴注。结果术后两组患者均无院内死亡。实验组术后左室射血分数(56±8)%显著高于组对照组(52±10)%,差异有统计学意义(t=1.711,P<0.05)。实验组无患者接受主动脉内球囊反搏,对照组6例接受主动脉内球囊反搏治疗,两组比较差异有统计学意义(χ2=6.67,P<0.05);实验组重症监护时间(18.97±5.70)h明显短于对照组(23.20±12.32)h,差异有统计学意义(t=-1.856,P<0.05);对照组住院时间为(11.30±3.43)d,显著长于实验组(9.33±1.45)d,差异有统计学意义(t=-2.38,P<0.05)。结论术前应用左旋卡尼汀预处理能够显著改善术后心功能,减少术后院内心脏事件的发生率。

Objective To study the effect of propionyl L-carnitine on patients operated for coronary artery bypass grafting.Methods From May 2006 to May 2009,total consecutive 60 patients accepted the coronary artery bypass grafting.All the patients were divided into two groups.Experimental group（n=30）：the patients were intravenous dripped with propionyl L-carnitine for pretreatment for 3 days before the operation.Control group（n=30）： the patients were intravenous dripped with 0.9% normal saline.Results There was no in-hospital death patient in two groups.left ventricular ejection fraction of Experimental group was （56±8）%,which was higher than control group （52±10）%,the difference was statistical significant（t=1.711,P〈0.05）.No patients in experimental group and 6 patients in control group required IABP,the difference of two groups was significant（χ^2=6.67,P〈0.05）.The ICU time of experimental group[（18.97±5.70） h]was shorter than that[（23.20±12.32） h]of control group,（t=-1.856,P〈0.05）.The time of total hospital stays also has statistical difference between two groups,control group[（11.30±3.43）d]was longer than that of experimental group[（9.33±1.45）d],（ t=-2.38,P〈0.05）.Conclusion Patients accepted pretreatment by propionyl L-carnitine before coronary artery bypass grafting can improve the heart function of postoperation and decrease the incidence rate of in-hospital heart incident postoperation.