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[目的]观察急性脑梗死患者,静脉滴注不同剂量的左-卡尼汀对血浆基质金属蛋白酶(MMPs)的影响。[方法]157例起病6~24h的急性脑梗死患者按入院时间序贯分为3组,治疗1组每日静脉滴注左-卡尼汀6g,连续14d;治疗2组每日静脉滴注左-卡尼汀3g,连续14d;对照组除不用左-卡尼汀外,其他治疗条件同前两组;入院时和入院后14d,对所有患者进行神经功能缺损评分(用斯堪的那维亚卒中量表)和意识障碍评分(用Glasgow-Pittsburgh量表)。[结果]①治疗1组患者血浆MMP-2在入院后3d到14d明显低于对照组(P﹤0.05),其中在入院后3d明显低于治疗2组(P﹤0.05);治疗1组患者血浆MMP-9从入院后3d到14d明显低于对照组和治疗2组(P﹤0.05)。②两组治疗14d后神经功能缺损评分和意识障碍评分差异无统计学意义(P﹥0.05)。[结论]左-卡尼汀可能通过降低脑缺血后血浆基质金属蛋白酶水平,对急性脑梗死患者有潜在的较好的神经保护作用。
[Objective] To observe the effect of intravenous infusion of left-carnitine on plasma matrix metalloproteinases (MMPs) in patients with acute cerebral infarction. [Method] A total of 157 acute cerebral infarction patients with onset of 6 ~ 24h were divided into 3 groups according to the sequence of hospital admission. The patients in treatment group 1 were given intravenous drip of carnosine 6g daily for 14 days. The daily intravenous drip Carnitine 3g, continuous 14d; control group without left carnitine, the other treatment conditions with the former two groups; admission and 14d after admission, all patients with neurological deficit score (using Scandinavian The Navio Stroke Scale) and the disturbance of consciousness score (using the Glasgow-Pittsburgh scale). [Results] ① The plasma MMP-2 levels in the treatment group 1 were significantly lower than those in the control group from the 3d to 14d after admission (P <0.05), and were significantly lower than those in the treatment 2 group on the 3rd day after admission (P <0.05) The plasma MMP-9 level was significantly lower than 3d and 14d after admission (P <0.05). ② After 14 days of treatment, there was no significant difference in neurological deficit score and disturbance of consciousness between the two groups (P> 0.05). [Conclusion] L-Carnitine may potentially have better neuroprotective effect in patients with acute cerebral infarction by decreasing the level of plasma matrix metalloproteinase after cerebral ischemia.