左卡尼汀对脓毒症线粒体靶向治疗的作用的研究.docVIP

左卡尼汀对脓毒症线粒体靶向治疗的作用的研究 　　【摘要】 目的：观察左卡尼汀能否作为代谢复苏药物改善脓毒症患者线粒体功能，并观察其治疗效果。方法：选取2014年2月-2017年2月本院就诊的脓毒症患者86例，采用随机数字表法分为常规治疗组（对照组）和左卡尼汀组（治疗组），每组43例，观察两组治疗前后血小板线粒体功能、乳酸清除率、SOFA评分、呼吸机辅助时间、ICU住院时间及短期（28 d）病死率。结果：治疗组治疗后血小板粒体跨膜电位和线粒体内ATP含量均优于治疗前且优于对照组，差异均有统计学意义（P0.05）；两组治疗后SOFA评分均下降，治疗组乳酸清除率高于对照组，SOFA评分低于对照组，呼吸机辅助时间、ICU住院时间明显缩短，短期病死率均低于对照组，差异均有统计学意义（P0.05）。结论：左卡尼汀通过改善线粒体功能，可以增加脓毒症患者乳酸清除率，提高组织器官能量供应，阻止器官衰竭，缩短呼吸机辅助时间及ICU住院时间，降低患者短期（28 d）死亡率。 　　【关键词】 脓毒症； 线粒体； 左卡尼汀； 代谢复苏 　　Effect Study of L-carnitine for Sepsis Mitochondrial Targeting Therapeutic/LI Li，WANG Feng.//Medical Innovation of China，2017，14（26）：021-024 　　【Abstract】 Objective：To observe whether L-carnitine can improve the mitochondrial function of sepsis as a metabolic resuscitation drug and its therapeutic effect.Method：From February 2014 to February 2017，86 patients with sepsis treated in our hospital were selected and divided into routine treatment group（the control group） and L-carnitine group（the treatment group） according to the random number table method，43 patients in each group.The platelet mitochondrial function，lactate clearance and SOFA scores before and after treatment，ventilator-assisted time，ICU hospitalization time and short-term（28 d） mortality of two groups were observed.Result：The levels of mitochondrial transmembrane potential and mitochondrial ATP content of the treatment group were improved compared with those before treatment and the control group，the differences were statistically significant（P0.05）.SOFA levels of two groups were decreased，and SOFA levels of the treatment group were lower than that of the control group，the duration of ventilator assisted，ICU hospitalization time and short-term mortality of the treatment group were were lower than those of the control group，the differences were statistically significant（P0.05）.Conclusion：L-carnitine can increase the lactic acid clearance rate for sepsis patients by improving the mitochondrial function，which can increase energy supply of tissues