非体外冠状动脉旁路移植术围术期应用左旋卡尼汀的疗效观察

The clinical observation of L-cartnine in the off.pump coronary artery bypass graft

目的 观察左旋卡尼汀在非体外冠状动脉旁路移植术围手术期使用的临床疗效.方法 选择160例行不停跳冠状动脉旁路移植术患者,完全随机分为对照组与左旋卡尼汀组,对2组术后主要症状改善等情况进行随机对照研究.结果 160例患者围手术期全部存活,左旋卡尼汀组与对照组相比,围手术期胸闷、心悸的发生率明显降低（1.25%比8.78%,1.25%比10.13%）;术后12、24 h心电图ST段变化及术后新发心房颤动的发生率明显降低（3.75%比10.00%,0比8.75%,1.25%比11.25%）;术后3个月的左心室射血分数明显增加[（57.66±5.45）%比（45.24±3.43）%],差异均有统计学意义（均P＜0.05）.结论 左旋卡尼汀是非体外冠状动脉旁路移植术围术期辅助治疗的良好选择.

Objective To observe the therapeutic effect of L-carnitine in the off-pump coronary artery bypass graft. Methods Totally 160 patients recieving off-pump coronary artery bypass graft were enrolled in the casecontrol study. Results One hundred and sixty patients all survived in the perioperative period. Compared with the control group, perioperative chest tightness and palpitations were significantly less （1.25% vs 8.78% , 1.25% vs 10. 13% ） in the L-camitine group; the ST-segment changes and the incidence of new atrial fibrillation was significantly lower （3. 75% vs 10.00% , 0 vs 8.75% , 1.25% vs 11.25%） after 12, 24 h; left ventricular ejection fraction increased significantly [（57.66 ± 5.45）% vs （45.24 ± 3.43）%] after 3 months. Conclusions L-camitine is a safe and effective therapy during perioperative period of off-pump coronary artery bypass graft.