左卡尼汀对急性心肌梗死PCI术患者血清H-FABP和cTnI水平的影响

Influence of L-carnitine on the Content of H-FABP and cTnI in Patients with Acute Myocardial Infarction after PCI

目的:探讨左卡尼汀对急性心肌梗死急诊行PCI治疗患者血浆心型脂肪酸结合蛋白(H-FABP)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(c Tn I)水平的影响。方法:选取笔者所在医院2012年11月-2014年12月收诊的100例急性心肌梗死患者作为研究对象,按照随机数字表法将其分为治疗组和对照组,每组50例。对照组按心血管指南行急诊PCI治疗,治疗组在此治疗基础上加用左卡尼汀3.0 g+0.9%氯化钠注射液250 ml静脉滴注(术中),以后1次/d,连续7 d。检测两组患者PCI术前及PCI术后6、12、24、48 h的血浆H-FABP、CKMB、c Tn I数值。结果:治疗组血浆H-FABP、CK-MB、c Tn I水平在术后相同时间点均较对照组降低,差异均有统计学意义(P<0.05)。行PCI术患者术后6 h血浆H-FABP明显高于术前(P<0.05),24 h恢复至术前水平。结论:左卡尼汀对缺血再灌注心肌细胞有保护作用,检测H-FABP有利于早期判断患者的心肌损伤,以便及早干预。

Objective： To investigate the curative effect of L-earnitine on the content of heart fatty acid binding protein（H-FABP）, creatine kirtase isoenzyme-MB（CK-MB） and myocardial troponin（cTnI） in acute myocardial infarction（AMI） patients with PCI.Method： A total of 100 AMI patients with PCI admitted to our hospital from November 2012 to December 2014 were selected as research objects, they were divided into the treatment group and the control group according to the random number table method, 50 cases in each group.The control group was treated with routine therapy, the treatment group was treated with Levocarnitine 3 g＋physiological saline 250 ml intravenous drip every day on the basis of above routine treatment for seven days.The H-FABP, CK-MB, cTnI in plasma of AMI Patients with PCI were detected before and after PCI 6, 12, 24, 48 h.Result： The H-FABP, CK-MB, cTnl levels in plasma of the treatment group at the same point of time after operation were significantly lower than those of the control group, the differences were statistically significant（P〈0.05）.The H-FABP level in plasma of patients with PCI after operation 6 h was significantly higher than the preoperative（P〈0.05）, after PCI 24 h recovered to the preoperative level.Conclusion： The L-carnitine on ischemia reperfusion injury of myocardial ceils has protective effect, detection of H-FABP is helpful in early diagnosis of myocardial injury in patients, to facilitate early intervention.