摘要
目的心绞痛为临床常见心血管疾病,寻找治疗心绞痛的有效、安全药物尤为重要。左卡尼汀为营养心肌的氨基酸新型药物,本研究观察左卡尼汀对不稳定性心绞痛患者的治疗疗效及对抗氧化、炎症指标影响。方法选取2016-04-01-2017-11-01黑龙江省康复医院收治的82例不稳定性心绞痛患者为研究对象,根据治疗方案分为常规组36例和干预组46例。常规组给予常规药物治疗;干预组在常规药物基础上,给予左卡尼汀2g/d静脉滴入,连续治疗7d后,改为口服左卡尼汀2g/d,连续治疗3个月。比较两组疗效、治疗前和治疗3个月后,谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、血清丙二醛(serum malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-6(interleukin-6,IL-6)水平及药物不良反应发生率。结果干预组治疗总有效率为97.83%,高于常规组的80.56%,χ2=5.021,P=0.025。治疗3个月后,干预组GSH-Px水平为(148.8±18.3)U/mL,高于常规组的(122.7±17.4)U/mL,t=6.548,P<0.001;干预组SOD水平为(86.4±13.4)U/mL,高于常规组的(79.6±12.7)U/mL,t=2.333,P=0.022;干预组MDA水平为(5.7±1.0)mmol/L,低于常规组的(6.5±1.2)mmol/L,t=3.292,P=0.002。治疗前,两组hs-CRP、TNF-α和IL-6水平比较,差异无统计学意义,均P>0.05。治疗3个月后,干预组hs-CRP水平为(1.7±0.4)mmol/L,低于常规组的(2.4±0.6)mmol/L,t=6.323,P<0.001;TNF-α水平为(11.4±2.3)pmol/L,低于常规组的(16.7±2.1)pmol/L,t=10.754,P<0.001;IL-6水平为(91.1±16.4)ng/L,低于常规组的(116.7±18.7)ng/L,t=6.595,P<0.001。干预组不良反应发生率为13.04%,与常规组的13.89%比较,差异无统计学意义,χ2=0.012,P=0.911。结论左卡尼汀治疗不稳定性心绞痛可改善患者氧化、炎症反应,提高治疗疗效。
OBJECTIVE Angina pectoris is a common cardiovascular disease in clinical practice.It is particularly important to find effective and safe drugs for the treatment of angina pectoris.Levocarnitine is a novel drug for myocardial amino acids nutrition.The aim of this study is to observe the therapeutic effect of L-carnitine on unstable angina pectoris and its influence on antioxidant and inflammatory indexes.METHODS A total of 82 patients with unstable angina pectoris diagnosed and treated in Heilongjiang Rehabilitation Hospital from April 1,2016 to November 1,2017 were retrospectively analyzed.According to the treatment plan,they were divided into conventional group(36cases)and intervention group(46cases).The conventional group received conventional drug treatment.The intervention group received an intravenous infusion of L-carnitine 2g/d on the basis of conventional drugs.After 7days of continuous treatment,it was changed to oral L-carnitine 2g/d for 3consecutive months.The glutathione peroxidase(GSH-Px),serum malondialdehyde(MDA),superoxide dismutase(SOD),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)levels and the incidence of adverse reactions were compared before and after treatment between the two groups.RESULTS The total effective rate of the intervention group was 97.83%,which was higher than that of the conventional group 80.56%,χ^2=5.021,P=0.025.After 3 months of treatment,the level of GSH-Px in the intervention group was(148.8±18.3)U/mL,which was higher than that of the control group(122.7±17.4)U/mL,t=6.548,P<0.001.The SOD level of the intervention group was(86.4±13.4)U/mL,which was higher than that of the conventional group(79.6±12.7)U/mL,t=2.333,P=0.022.The MDA level of the intervention group was(5.7±1.0)mmol/L,which was lower than that of the conventional group(6.5±1.2)mmol/L,t=3.292,P=0.002.Before treatment,there were no significant differences in hs-CRP,TNF-α,and IL-6levels between the two groups,all P>0.05.After 3months of treatment,the hs-CRP level in the intervention group was(1.7±0.4)mmol/L,which was lower than that in the conventional group(2.4±0.6)mmol/L,t=6.323,P<0.001.The TNF-αlevel was(11.4±2.3)pmol/L,lower than that of the conventional group(16.7±2.1)pmol/L,t=10.754,P<0.001.IL-6level was(91.1±16.4)ng/L,lower than that of the conventional group(116.7±18.7)ng/L,t=6.595,P<0.001.The incidence of adverse reactions in the intervention group was 13.04%,which was not statistically significant compared with 13.89%in the conventional group,χ^2=0.012,P=0.911.CONCLUSION Treatment with levocarnitine in patients with unstable angina can improve the patients’ oxidative and inflammatory reactions and improve the efficacy of the patient.
作者
奚宁宁
于彦伟
XI Ning-ning;YU Yan-wei(Department of Rehabilitation,Heilongjiang Convalescent Hospital,Harbin 150086,P.R.China;Chest Pain Center,Fourth Clinical Medical College,Harbin Medical University,Harbin 150001,P.R.China)
出处
《社区医学杂志》
2018年第20期1532-1535,共4页
Journal Of Community Medicine
基金
黑龙江省卫生厅科研课题(2009-049)
作者简介
通讯作者:奚宁宁,男,黑龙江哈尔滨人,主治医师,主要从事心血管内科的临床研究工作。E-mail:axpa@163.com.
