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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患儿27例分为左卡尼汀治疗组(A组,14例)和常规治疗组(B组,13例),两组患儿均予常规治疗,A组加用左卡尼汀针剂0.1g·kg-1·d-1静脉滴注,每日1次,治疗7d。治疗前和治疗7d后,采用RT-PCR法检测患儿静脉血中肉碱脂酰转移酶Ⅰ肝亚型(CPT-ⅠA)、肉碱脂酰转移酶Ⅰ肌肉亚型(CPT-ⅠB)和中链脂酰辅酶A脱氢酶(ACADM)mRNA表达水平。结果治疗后,A组CPT-ⅠB和ACADM mRNA表达水平为1.03±0.14和0.79±0.09,均高于B组的0.70±0.12和0.59±0.08(P<0.05)。结论左卡尼汀促进CPT-ⅠB和ACADM参与脂肪酸β氧化,是保护新生儿窒息后受损害心肌的可能机制。
Objective To investigate the protective effect of levocarnitine on impaired myocardium after neonatal asphyxia. Methods Twenty-seven children with myocardial damage caused by asphyxia were divided into L-carnitine treatment group (A group, 14 cases) and conventional treatment group (B group, 13 cases). Both groups were given routine treatment. A group Carnitine injection 0.1g · kg-1 · d-1 intravenous infusion, once a day for 7 days. Before treatment and 7 days after treatment, the levels of carotenoid acyltransferase Ⅰ hepatic subtype (CPT-ⅠA), carnitine acyltransferase Ⅰ muscle subtype (CPT-ⅠB) and Medium chain fatty acyl-CoA dehydrogenase (ACADM) mRNA expression levels. Results After treatment, the expressions of CPT-ⅠB and ACADM mRNA in group A were 1.03 ± 0.14 and 0.79 ± 0.09, respectively, which were significantly higher than those in group B (0.70 ± 0.12 and 0.59 ± 0.08, P <0.05). Conclusion L-carnitine promotes CPT-ⅠB and ACADM to participate in fatty acid β-oxidation, which is a possible mechanism for protecting the damaged myocardium after neonatal asphyxia.