左卡尼汀对冠心病患者血管内皮功能的保护作用

Protective effective of L-carnitine on vascular endothelial function of patients with coronary heart disease

目的探讨左卡尼汀对冠心病患者血管内皮功能的保护作用。方法选取武汉科技大学附属天佑医院2014年4月至2016年12月符合标准的60例冠心病患者,按随机数字表法分为治疗组和对照组,每组30例,对照组采用常规治疗,治疗组在对照组治疗基础上加用左卡尼汀2.0 g静脉滴注,每天1次,连续7 d。检测两组患者治疗前,治疗后24 h、7 d的一氧化氮(NO)和血浆降钙素基因相关肽(CGRP)水平,统计两组患者随访3个月内心脏不良事件发生率及再入院率。结果两组患者治疗前NO和CGRP水平比较,差异均无统计学意义(P>0.05);与治疗前比较,两组患者治疗后NO和CGRP水平均有不同程度升高,且治疗组较对照组升高更明显,差异均有统计学意义(P<0.05)。治疗组患者心律失常、心力衰竭(NYHA 3~4级)和再入院比例均低于对照组,差异均有统计学意义(P<0.05);两组患者再发急性冠状动脉综合征比例及病死率比较,差异均无统计学意义(P>0.05)。结论左卡尼汀能够保护冠心病患者的血管内皮功能,减少心脏不良事件发生。

Objective To investigate the protective effect of L-carnitine on vascular endothelial function of patientswith coronary heart disease(CHD). Methods A total of 60 CHD patients,who met the diagnostic criteria of CHD in TianyouHospital Affiliated to Wuhan University of Science & Technology from April 2014 to December 2016,were randomized intotreatment group and control group,30 cases in each group. The control group was treated with routine therapy,while the treat-ment group was treated with L-carnitine 2.0 g for intravenous drip on the basis of routine treatment,once a day for 7 d. The con-centrations of NO and plasma calcitonin gene related peptide(CGRP)were detected in both groups before treatment and 24 h,7 dafter treatment,meanwhile the cardiac adverse events and readmission rate in the two groups were calculated within 3 months fol-low-up. Results There was no statistically significant difference on concentrations of NO and CGRP between the two groups(P>0.05); compared with before treatment,the concentrations of NO and CGRP after treatment in both groups increased to varyingdegrees,moreover,the concentrations in the treatment group increased more obviously than those in the control group,with sta-tistically significant difference(P<0.05). The proportions of arhythmia,cardiac failure and readmission in the treatment groupwere lower than those in the control group,and the difference had statistical significance(P<0.05). The difference showed nostatistical significance on recurrence rate in patients with acute coronary syndrome and fatality rate between the two groups(P>0.05). Conclusion L-carnitine can protect vascular endothelial function of patients with coronary heart disease,and re-duce the occurrence rate of cardiac adverse events.