Ramos A C, Elias P R, Barrucand L, Da Silva J A
Pediatr Res. 1984 Sep;18(9):815-9. doi: 10.1203/00006450-198409000-00001.
Carnitine, an important cofactor in the transport of fatty acids to the interior of cell mitochondria, is depleted in myocardial tissue of guinea pigs submitted to diphtheric toxin administration. Mortality rates were reduced in these animals by supplying exogenous amounts of carnitine. The accumulation of fatty acids in the cytoplasm of human heart cells reported in cases of diphtheria suggests that carnitine might possibly be depleted in human myocardium as well. For the purpose of studying the effect of carnitine administration, 132 diphtheric patients were randomly divided into two groups, one of them (carnitine-treated group, n = 73) receiving DL-carnitine, 100 mg/kg/day during 4 days after admission, in addition to routine treatment, which was prescribed for this and the control group (n = 59). The presence of myocardial damage was evaluated by clinical, electrocardiographic, radiological, and enzymatic criteria. Carnitine administration resulted in decreased incidence of heart failure (P = 0.0475), of pacemaker implants (P = 0.0256), and of lethality indexes due to myocarditis (P = 0.013). We suggest that carnitine can play an important role in the treatment of diphtheric patients.
肉碱是脂肪酸转运至细胞线粒体内的一种重要辅助因子，对白喉毒素处理的豚鼠心肌组织而言，其含量会减少。通过提供外源性肉碱，这些动物的死亡率降低。白喉病例中所报道的人类心脏细胞细胞质内脂肪酸的蓄积表明，人类心肌中的肉碱也可能会减少。为了研究给予肉碱的效果，132例白喉患者被随机分为两组，其中一组（肉碱治疗组，n = 73）除了接受该组及对照组（n = 59）所规定的常规治疗外，在入院后4天内每天接受100 mg/kg的DL-肉碱治疗。通过临床、心电图、放射学和酶学标准评估心肌损伤的存在情况。给予肉碱使心力衰竭的发生率降低（P = 0.0475），起搏器植入率降低（P = 0.0256），因心肌炎导致的致死率指数降低（P = 0.013）。我们认为肉碱在白喉患者的治疗中可发挥重要作用。
