多巴胺联合左卡尼汀对急性心肌梗死患者PCI术后缺血再灌注损伤的影响

Effect of dopamine combined with L-carnitine on reperfusion injury in patients with acute myocardial infarction after PCI

目的 探讨多巴胺联合左卡尼汀对急性心肌梗死患者经皮冠状动脉介入治疗(PCI)术后缺血再灌注损伤的影响。方法 选择2018年2月至2020年3月金华市中心医院收治的急性心肌梗死行急诊PCI患者106例,按病案号尾数奇偶数分为观察组(常规治疗基础上给予多巴胺联合左卡尼汀治疗)和对照组(常规治疗基础上给予左卡尼汀治疗)各53例。比较两组患者治疗前后乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(α-HBDH)、天门冬氨酸氨基转移酶(AST)、心肌肌钙蛋白T(c Tn T)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室射血分数(LVEF)。出院后两组患者均随访3个月,比较主要不良心血管事件(MACE)发生率。结果 两组患者治疗后LDH、CK、CK-MB、AST、α-HBDH、c Tn T、LVEDd、LVESd均低于治疗前,LVEF高于治疗前,差异均有统计学意义(均P<0.05)。观察组治疗后LDH、CK、CK-MB、AST、α-HBDH、c Tn T、LVEDd、LVESd均低于对照组,LVEF高于对照组,差异均有统计学意义(均P<0.05)。观察组MACE发生率(1.89%)低于对照组(15.09%),差异有统计学意义(P<0.05)。结论 多巴胺联合左卡尼汀可明显减轻急性心肌梗死患者PCI术后缺血再灌注心损伤和改善预后。

Objective To investigate the effect of dopamine combined with L-carnitine on myocardial reperfusion injury in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods One hundred and six AMI patients underwent PCI in Jinhua Municipal General Hospital from February 2018 to March 2020 were divided into the observation group(dopamine combined with L-carnitine based on conventional drug treatment)and the control group(L-carnitine based on conventional drug treatment)by the last number according to the medical record number,53 cases in each group.In addition to routine treatment,the observation group was treated with dopamine combined with L-carnitine,and the control group was treated with L-carnitine.Serum LDH,CK,CK-MB,α-HBDH,AST,cTnT,left ventricular end diastolic and systolic diameter(LVEDd,LVESd)and left ventricular ejection fraction(LVEF)were compared between groups.All patients were followed up for 3 months after discharge.The incidence of major adverse cardiovascular events(MACE)was compared between groups during follow-up 3 months after discharge.Results LDH,CK,CK-MB,AST,α-HBDH,cTnT,LVEDd and LVESd decreased and LVEF increased significantly in both groups after treatment than before(all P<0.05).LDH,CK,CK-MB,ASTα-HBDH,cTnT,LVEDd and LVESd were significantly lower and LVEF was significantly higher in the observation group than in the control group after treatment(all P<0.05).The incidence of MACE was significantly lower in the observation group than in the control group(1.89%vs.15.09%,P<0.05).Conclusion Dopamine combined with L-carnitine can reduce myocardia reperfusion injury and improve prognosis of patients with AMI after PCI.