CAJ | 학술논문

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7d。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7d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。
목적：탐토좌잡니정대신생인질식후수손해심기적보호작용。방법질식치심기손해신생인44례분위치료조21례화대조조23례，2조환인균여상규치료，치료조가용좌잡니정침0.1 g/（kg·d）정맥적주，매일1차，치료7d。관찰치료전이급치료과정중환인증상체정적변화。치료전화치료7d후，시제합검측환인정맥혈혈장유리좌잡니정화혈장기개단백I（cTnI）수평。결과치료조림상유효솔명현고우대조조（90.48%vs 60.87%，P<0.05）。치료후，치료조유리좌잡니정수평고우대조조[（27.00±5.69）μmol/L vs（13.20±3.04）μmol/L，P<0.05]。치료조치료후혈장유리좌잡니정고우치료전[（14.87±3.95）μmol/L，P<0.05]。치료후，치료조혈장cTnI저우대조조[（0.025±0.006）μg/L vs（0.046±0.010）μg/L，P<0.05]。치료조cTnI하강치여유리좌잡니정증가치지간유명현상관성（r=0.899，P<0.05）。결론좌잡니정능유효강저유심기손해적질식신생인이상혈장cTnI수평，기도보호심기적작용。
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.