左卡尼汀对急性心肌梗死患者血清Ⅲ型前胶原氨基端肽及左室重构的影响

Effects of L-carnitine on serum concentration of PIIINP and left ventricular remodling in patients with acute myocardial infarction

目的 观察左卡尼汀对急性心肌梗死（AMI）患者血清Ⅲ型前胶原氨基端肽（PⅢNP）及左室重构的影响.方法 104例AMI患者被随机分为常规治疗组（52例）和左卡尼汀治疗组（52例）.两组均给予常规治疗,左卡尼汀治疗组在此基础上加用左卡尼汀3.0 g静脉滴注,每日1次,14 d为1个疗程,治疗3个疗程,每个疗程间隔2 d.用放射免疫法测定血清PⅢNP及血浆内皮素（ET）的含量.采用彩色Doppler超声心动图仪测量左室舒张末期容积指数（LEDVI）、左室收缩末期容积指数（LESVI）及左室射血分数（LVEF）.结果 AMI后血清PⅢNP及血浆ET水平升高（P〈0.01）.左卡尼汀治疗组在治疗4、6周时与常规治疗组相比,血清PⅢNP及血浆ET均明显减低（P〈0.05或P〈0.01）,LEDVI、LESVI、LVEF较常规治疗组显著改善（P〈0.05）,且6周时优于4周（P〈0.05）.结论 左卡尼汀能降低AMI患者血清PⅢNP水平,改善左室重构.

Objective To investigate the effect of L-carnitine on the levels of serum aminoterminal propeptide of type Ⅲ procollage （Pm NP） and left ventricular remodeling in patients with acute myocardial Infarction （AMI）. Methods 104 patients with AMI were randomly divided into routine treating group （52 cases） and L-carnitine treating group （52 cases）. Routine treatments were given to the two groups, and 3.0 g L-carnitine was added in the L-carnitine treating group by intravenous drip once per day for 3 courses, 14 days constituted one therapeutic course and the interval between the 2 courses was 2 days. The serum P Ⅲ NP and plasma endothelin （ET） were measured by specific radioimmunoassay. Color Doppler echocardiography was performed to determine left ventricular end diastolic volume index （LEDVI）, left ventricular end systolic volume index （LESVI） and left ventricular ejection fraction （LVEF）. Results After AMI, serum PmNP and plasma ET were significantly increased. In the 4th and 6th weeks serum P Ⅲ NP and plasma ET were significantly reduced in the L-carnitine treating group comparison with routine treating group. LEDVI ,LESVI and LVEF were significantly improved between the two groups and more improved in the 6th weeks than those in the 4th weeks after admission in the L-carnitine treating group. Coulusion L-carnitine can decrease the P Ⅲ NP and reverse left ventricular remodeling in patients with AMI.