天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (9): 1034-1036.doi: 10.11958/j.issn.0253-9896.2015.09.021

• 药物临床观察 • 上一篇    下一篇

左卡尼汀治疗新生儿窒息后血浆肌钙蛋白I异常的效果

盛俞1， 丛辉2， 郭飞1， 徐美玉1， 张弘3   

  1. = 1南通大学附属医院儿科 （邮编226001）， 2检验科， 3消化病实验室
  • 收稿日期:2014-12-10 修回日期:2015-04-21 出版日期:2015-09-15 发布日期:2015-09-15
  • 通讯作者: 盛俞 E-mail:nttbntsy@sina.com
  • 作者简介:盛俞 （1971）， 女， 副主任医师， 硕士研究生， 主要从事新生儿医学研究
  • 基金资助:
    江苏省 “六大人才高峰” 资助项目 （ws-066）； 南通大学自然科学项目 （10Z060）

Curative effect of L-carnitine on neonatal abnormal cardiac troponin I caused by asphyxia

SHENG Yu1, CONG Hui2, GUO Fei1, XU Meiyu1, ZHANG Hong3   

  1. 1Department of Pediatrics, 2 Department of Clinical Laboratory, 3 Laboratory of Digestive Disease, Affiliated Hospital of Nantong University, Nantong 226001,China
  • Received:2014-12-10 Revised:2015-04-21 Published:2015-09-15 Online:2015-09-15

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摘要： 目的 探讨左卡尼汀对新生儿窒息后受损害心肌的保护作用。方法 窒息致心肌损害新生儿 44 例分为治疗组 21 例和对照组 23 例， 2 组患儿均予常规治疗， 治疗组加用左卡尼汀针 0.1 g/ （kg·d） 静脉滴注， 每日 1 次， 治疗 7 d。观察治疗前以及治疗过程中患儿症状体征的变化。治疗前和治疗 7 d 后， 试剂盒检测患儿静脉血血浆游离左卡尼汀和血浆肌钙蛋白 I （cTnI） 水平。结果 治疗组临床有效率明显高于对照组 （90.48% vs 60.87%， P < 0.05）。治疗后， 治疗组游离左卡尼汀水平高于对照组[ （27.00±5.69） μmol/L vs（13.20±3.04） μmol/L， P < 0.05]。治疗组治疗后血浆游离左卡尼汀高于治疗前[ （14.87±3.95） μmol/L， P < 0.05]。治疗后， 治疗组血浆 cTnI 低于对照组[ （0.025±0.006） μg/L vs（0.046±0.010） μg/L， P < 0.05]。治疗组 cTnI 下降值与游离左卡尼汀增加值之间有明显相关性 （r=0.899， P < 0.05）。结论 左卡尼汀能有效降低有心肌损害的窒息新生儿异常血浆cTnI 水平， 起到保护心肌的作用。

关键词: 窒息,新生儿, 肌钙蛋白I, 左卡尼汀, 治疗结果, 药物评价

Abstract: Objective To explore the protective effect of L-carnitine on neonates with myocardial injury caused by as⁃ phyxia. Methods Forty-four neonates with myocardial injury caused by asphyxia were randomly divided into L-carnitine treatment group (21 cases) and control group (23 cases). Patients in control group were received routine treatment and pa⁃ tients in treatment group were given L-carnitine 0. 1 g/(kg·d) on the basis of routine treatment for 7 days. Symptoms and physical signs were observed before therapy and during the treatment in two groups. Before and after the treatment, plasma levels of free L-carnitine and cardiac troponin I (cTnI) were detected with the method of colorimetric assay and chemilumi⁃ nescent, respectively. Results The clinical effective rate was significantly higher in treatment group than that of control group (90.48% vs 60.87%, P < 0. 05). Compared with the control group, there was a significantly higher plasma concentra⁃ tion of free L-carnitine in treatment group after treatment [(27.00±5.69) μmol/L vs (13.20±3.04) μmol/L, P < 0.05]. In treat⁃ ment group, plasma concentration of free L- carnitine was significantly higher after treatment than that of pre- therapy [(14.87±3.95) μmol/L， P < 0.05]. Compared with the control group, there was a significantly lower plasma concentration of cTnI after treatment in treatment group [(0.025±0.006) μg/L vs (0.046±0.010) μg/L, P < 0.05]. In the treatment group, there was a significant correlation between decreased plasma concentration of cTnI and increased plasma concentration of free L- carnitine (r=0.899, P < 0.05). Conclusion Administration of L-carnitine can effectively decrease the abnormal plasma lev⁃ el of cTnI in neonates with myocardial injury caused by asphyxia, and thereby protect the myocardium.

Key words: asphyxia neonatorum, troponin I, L- carnitine, treatment outcome, drug evaluation