Mohammadi Mohammad, Hajhossein Talasaz Azita, Alidoosti Mohammad, Pour Hosseini Hamid Reza, Gholami Kheirollah, Jalali Arash, Aryannejad Hamid
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2017 Apr;12(2):57-64.
L-carnitine may prevent the incidence of AKI by its antioxidant effects and improving circulation in ischemic conditions. The goal of this trial was to evaluate the impact of L-carnitine on contrast-induced nephropathy in patients undergoing elective PCI. Totally, the patients were randomly allocated to 2 groups. The treatment group received 1 g of L-carnitine orally 3 times a day, 24 hours before the procedure (3 g before PCI) and 2 g after PCI, whereas the control group did not receive L-carnitine. In both groups, the plasma level of neutrophil gelatinase-associated lipocalin (NGAL) was measured at baseline and 12 hours after PCI. Our study was conducted on 202 patients (including 91 vs. 111 patients in the treatment and the control group; 31 (34.1%) vs 33 (29.7%) female in carnitine and control group; and ages include 62.0 ± 9.0 vs 57.0 ± 11.2 years). The median plasma levels of NGAL were not different between the carnitine and control groups at baseline (57 [IQR: 22 - 255] vs. 54 [IQR: 29 - 324]; p value = 0.155) and 12 hours after PCI (71 [IQR: 52 - 129] vs. 70 [IQR: 46 - 153]; p value = 0.925), but the changes in the plasma NGAL from baseline to 12 hours after PCI were different between the 2 groups (5 [IQR:-147 - 30] vs. 17 [IQR: -21 - 41]; p value = 0.010). Our results showed that oral L-carnitine was able to prevent an increase in NGAL following contrast medium administration in patients undergoing PCI. More studies should be performed to fully elucidate the nephroprotective effects of L-carnitine.
左旋肉碱可能通过其抗氧化作用以及改善缺血状态下的循环来预防急性肾损伤的发生。本试验的目的是评估左旋肉碱对接受择期经皮冠状动脉介入治疗（PCI）患者的造影剂肾病的影响。总共，患者被随机分为两组。治疗组在手术前24小时（PCI前3克）和PCI后2克，每天口服3次1克左旋肉碱，而对照组未接受左旋肉碱。在两组中，在基线和PCI后12小时测量中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的血浆水平。我们的研究对202例患者进行（治疗组91例，对照组111例；左旋肉碱组和对照组女性分别为31例（34.1%）和33例（29.7%）；年龄分别为62.0±9.0岁和57.0±11.2岁）。在基线时，左旋肉碱组和对照组的NGAL血浆中位数水平无差异（57[四分位间距：22 - 255]对54[四分位间距：29 - 324]；p值 = 0.155），PCI后12小时也无差异（71[四分位间距：52 - 129]对70[四分位间距：46 - 153]；p值 = 0.925），但两组从基线到PCI后12小时的血浆NGAL变化不同（5[四分位间距：-147 - 30]对17[四分位间距：-21 - 41]；p值 = 0.010）。我们的结果表明，口服左旋肉碱能够预防接受PCI患者在使用造影剂后NGAL的升高。应进行更多研究以充分阐明左旋肉碱的肾保护作用。
