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AIM: To explore the efficacy of torasemide combined with levocarnitine in the treatment of chronic heart failure (CHF). METHODS: From July 2018 to July 2020, 75 patients with CHF were recruited and randomly assigned into the control group (37 cases) and the study group (38 cases) according to the random number table method. The control and study groups were treated with levocarnitine and the combination of levocarnitine and torasemide, respectively. The clinical efficacy of the two groups was evaluated. The ventricular remodeling indexes and 6-minute walk test (6MWT) distance were compared between the two groups before and after treatment. The serum levels of serum galectin-3 (Gal-3), interleukin-33 (IL-33), hypersensitive C-reactive protein (hs-CRP), and the plasma concentrations of N terminal pro B type natriuretic peptide (NT-proBNP) and brain natriuretic peptide (BNP) were determined. RESULTS: (1) After treatment, the total clinical effective rate of the study group (92.11%) was higher than that of the control group (72.97%) (P<0.05). (2) The diastolic interventricular septal thickness (IVST) and diastolic left ventricular posterior wall thickness (LVPWT) were decreased following the treatment in both groups (P<0.05), whereas the treatment led to the increases of the left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in both groups (P<0.05). Compared with those in the control group, IVST and LVPWT in the study group were lower (P<0.05), and LVMI and LVEF were higher (P<0.05). (3) The levels of serum Gal-3, IL-33 and hs-CRP in the two groups were decreased after treatment (P<0.05); compared with those in the control group, the levels of serum Gal-3, IL-33 and hs-CRP were reduced to a greater extent in the study group (P<0.05). (4) Compared with that before treatment, 6MWT distance in both groups increased after treatment (P<0.05); the improvement in the study group was more significant relative to those in the control group (P<0.05). (5) Compared with before treatment, the expression levels of plasma NT-proBNP and BNP in the two groups were decreased after treatment (P<0.05); the reduction of plasma NT-proBNP and BNP levels in the study group was greater than the control group (P<0.05). CONCLUSION: Torasemide combined with levocarnitine is more effective than levocarnitine monotherapy in the treatment of CHF and can significantly improve ventricular remodeling index and motor function, reduce serum inflammation, and enhance cardiac function with definite curative effect.
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【Objective】 To investigate the effect and prognosis of Roxastat combined with levocarnitine and polysaccharide iron complex in patients with chronic renal failure hemodialysis anemia(CRFHA). 【Methods】 A total of 70 patients with CRFHA treated in our hospital from January 2019 to December 2020 were selected as study subjects. They were divided into control group and treatment group by simple randomizaiton grouping method. After 5 cases in each group dropped out due to transfer, COVID-19 epidemic and missed follow-up, 30 cases were left in each group.The control group was treated with Roxastat, and the treatment group with L-carnitine and polysaccharide iron complex based on Roxastat. The differences in anemia parameters, iron metabolism, dialysis-related indexes and complications between the two groups were observed and compared. 【Results】 After 3 months of treatment, Hb, RBC, Hct, TIBC, FE, and FERR in the treatment group were significantly higher than those in the control group (118.36±6.64 vs 109.34±6.25, 4.32±0.264 vs 4.03±0.32, 32.37±3.30 vs 29.85±3.24, 67.62±10.66 vs 62.78±10.32, 17.87±3.81 vs 12.51±3.82, 389.37±18.30 vs 362.85±18.04, respectively, P0.05). Blood creatinine of patients after 3 months of treatment was significantly higher (control group: 1 016.27±122.14 vs 1 052.27±96.23; observation group 1 014.23±121.57 vs 1 056.25±96.82, P<0.05); blood phosphorus (control group: 2.21±0.21vs 2.14±0.21; observation group: 2.23±0.30 vs 2.15±0.64) was significantly lower(P<0.05); blood calcium (control group: 2.07±0.51 vs 1.85±0.54; observation group 2.05±0.50 vs 1.87±0.52) was significantly lower (P<0.05 ). A comparison of complications between the two groups of patients after 6 months of treatment showed that the combined incidence of gastrointestinal function, increased blood pressure, and fever in the treatment group was lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】 Roxastat combined with L-carnitine and polysaccharide iron complex in patients with CRFHA has definite effect, which improves dialysis-related indicators, has great advantages in optimizing anemia parameters and iron metabolism, and provides reference value for clinical treatment of CRFHA
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Objective To investigate the effect of intravenous drip of levocarnitine during perioperative period on serum cytokines and cardiac troponin (cTn) I in patients undergoing coronary artery bypass grafting (CABG) under extracorporeal circulation. Methods The clinical data of 70 patients who had underwent CABG under extracorporeal circulation in Department of Cardiovascular Surgery, the First Affiliated Hospital of Medical College of Xi′an Jiaotong University from January 2015 to December 2017 were retrospectively analyzed. Among them, 35 cases were treated with intravenous infusion of levocarnitine (experiment group), and 35 cases were not treated with intravenous infusion of levocarnitine (control group). The serum levels of cTnI, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 and IL-10 1 h before operation and 2, 6, 24, 72 h after aorta open were detected; the postoperative recovery and complication were recorded. Results There were no statistical differences in TNF-α, IL-6, IL-8, IL-10 and cTnI before operation between 2 groups (P＞0.05); the indexes 2, 6, 24 and 72 h after aorta open were significantly higher than those before operation, and there were statistical differences (P＜0.05). The TNF-α, IL-6 and cTnI 2, 6, 24 and 72 h after aorta open in experiment group were significantly lower than those in control group, and the IL-10 was significantly higher than that in control group; the IL-8 2, 6 and 24 h after aorta open in experiment group were significantly lower than that in control group, and there were statistical differences (P＜0.05). The ICU monitoring time, electrocardio-monitoring time, duration of antibiotic treatment, duration of drainage tube, mechanical ventilation time and length of hospital stay in experiment group were significantly shorter than those in control group: (2.9 ± 0.5) d vs. (3.5 ± 0.8) d, (5.7 ± 1.8) d vs. (7.6 ± 3.2) d, (6.7 ± 1.5) d vs. (9.8 ± 2.2) d, (3.1 ± 0.8) d vs. (3.9 ± 1.4) d, (3.3 ± 2.1) d vs. (5.1 ± 2.3) d and (8.1 ± 2.2) d vs. (12.8 ± 2.6) d, and there were statistical differences (P＜0.01). Moreover, there were no severe perioperative complications such as myocardial infarction and pulmonary infection in 2 groups. Conclusions Intravenous drip of levocarnitine during perioperative period could effectively control postoperative inflammatory response and myocardial injury in patients undergoing CABG under extracorporeal circulation. The effect of levocarnitine may be related to its ability to balance the levels between proinflammatory cytokines and anti-inflammatory cytokines.
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Objective To observe the neuro-protective effect of Levocarnitine on severe hand,foot and mouth disease (HFMD) after enterovirus 71 (EV71) infection,to preliminarily explore the possible mechanism preliminarily.Methods One hundred and thirty-two children with EV71 infection and HFMD combined with serum S100 protein and neuronspecific enolase (NSE) abnormalities who were admitted to Chihlren's Hospital Affiliated to Zhengzhou University from March 2015 to July 2016 were enrolled in the study.They were divided into the routine group and the Levocarnitine group by the random number grouping method.The routine group (66 cases,including 32 males and 34 females,median age of 2 years and 3 months) was given symptomatic treatment such as antiviral therapy while the Levocarnitine group (66 cases,including 36 males and 30 females,median age of 2 years and 5 months) was treated with Levocarnitine for neuroprotection on the basis of routine group.Forty healthy children (23 males and 17 females,median age of 2 years and 6 months) who were examined at the Children's Hospital Affiliated to Zhengzhou University during the same period were selected as the healthy control group.The levels of S100,NSE,soluble apoptosis-related factors (sFas),soluble apoptosis-related factor l igands (sFasL),malondialdehyde (MDA),superoxide dismutase (SOD) in serum were compared between the healthy control group and children with HFMD.The levels of above-mentioned indexes in cerebrospinal fluid and serum,efficacy-related indicators such as duration of fever,white blood cell count on the 3rd day of treatment,time to remission of nervous system symptoms,time of disease progression and critical conversion rate were compared between 2 groups of children with HFMD.The correlation between sFas,sFasL,MDA,SOD and S100,NSEwas performed Results (1) The levels of S100 [(0.38:±:0.16) μg/Lvs.(0.06:±:0.23) μg/L],NSE [(43.70±8.80) μg/Lvs.10.10±3.60) μg/L],sFas [(6.61 ±1.86) μg/Lvs.(3.88±1.22) μg/L],sFasL [(101.40±20.7) μg/Lvs.(54.4±13.3) μg/L] and MDA[(11.98±2.54) nmol/Lvs.(4.08±1.45) nmol/L]in serum of HFMD group were significantly higher than those of the healthy control group (t =-12.245,-22.895,-8.273,-12.803,-17.960,all P ＜0.05),while the SOD level [(57.10 ± 10.40) kU/L vs.(70.3 ±14.4) kU/L] was significantly lower (t =5.457,P ＜ 0.05).(2) With the extension of treatment time for HFMD children in the two groups,S100 and NSE in cerebrospinal fluid,S100,NSE,sFas,sFasL and MDA in serum decreased,while SOD level increased.On the 3rd and 7th day after treatment,S100 (t3 =3.491,t7 =14.434),NSE (t3 =2.920,t7 =23.490) in cerebrospinal fluid,S100 (t3 =5.277,t7 =3.614),NSE (t3 =4.652,t7 =10.525),sFas (t3 =6.399,t7 =7.514),sFasL (t3 =11.155,t7 =8.804) and MDA (t3 =6.348,t7 =7.499) in serum of Levocarnitine group were significantly lower than those of routine group (all P ＜ O.05),while SOD (t3 =3.162,t7 =-3.529) was significantly higher than that of routine group (P ＜0.05).(3) The relief time of neurological symptom in levocarnitine group was significantly shorter than that in the routine group [(1.23 ± 0.65) d vs.(1.84 ± 0.47) d],and WBC on the 3rd day after treatment [(9.14 ± 2.93) × 109/L vs.(7.12 ± 2.58) × 109/L] and the progression time of the disease [(29.74 ± 7.85) h vs.(17.36 ± 8.73) h] were significantly better than the those in the routine group (t =-6.178,4.204,8.567,all P ＜ 0.05).The critical conversion rates of Levocarnitine group and the routine group were 7.58％ and 18.18％,respectively,and the difference in critical conversion rate was not statistically significant (x2 =2.316,P ＞0.05).(4)There was a positive correlation between S100 and sFas,sFasL,MDA in children with HFMD (r =0.373,0.735,0.334,P ＜ 0.05).NSE was positively correlated with sFas and sFasL (r =0.479,0.601,all P ＜0.05),while SOD and S100 were negatively correlated with NSE (r =-0.425,-0.460,all P ＜ 0.05).Conclusions Levocarnitine has good curative effect on severe HFMD in children infected by enterovirus EV71,which can effectively protect the cranial nerves.The mechanism may be related to scavenging oxygen free radicals and blocking nerve cell apoptosis.
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Objective@#To observe the neuro-protective effect of Levocarnitine on severe hand, foot and mouth disease (HFMD) after enterovirus 71(EV71) infection, to preliminarily explore the possible mechanism preliminarily.@*Methods@#One hundred and thirty-two children with EV71 infection and HFMD combined with serum S100 protein and neuronspecific enolase (NSE) abnormalities who were admitted to Children′s Hospital Affiliated to Zhengzhou University from March 2015 to July 2016 were enrolled in the study.They were divided into the routine group and the Levocarnitine group by the random number grouping method.The routine group (66 cases, including 32 males and 34 females, median age of 2 years and 3 months) was given symptomatic treatment such as antiviral therapy while the Levo-carnitine group (66 cases, including 36 males and 30 females, median age of 2 years and 5 months) was treated with Levocarnitine for neuroprotection on the basis of routine group.Forty healthy children (23 males and 17 females, median age of 2 years and 6 months) who were examined at the Children′s Hospital Affiliated to Zhengzhou University during the same period were selected as the healthy control group.The levels of S100, NSE, soluble apoptosis-related factors (sFas), soluble apoptosis-related factor ligands (sFasL), malondialdehyde (MDA), superoxide dismutase (SOD) in serum were compared between the healthy control group and children with HFMD.The levels of above-mentioned indexes in cerebrospinal fluid and serum, efficacy-related indicators such as duration of fever, white blood cell count on the 3rd day of treatment, time to remission of nervous system symptoms, time of disease progression and critical conversion rate were compared between 2 groups of children with HFMD.The correlation between sFas, sFasL, MDA, SOD and S100, NSE was performed@*Results@#(1) The levels of S100 [(0.38±0.16) μg/L vs. (0.06±0.23) μg/L], NSE [(43.70±8.80) μg/L vs. 10.10±3.60) μg/L], sFas [(6.61±1.86) μg/L vs. (3.88±1.22) μg/L], sFasL[(101.40±20.7) μg/L vs. (54.4±13.3) μg/L] and MDA[(11.98±2.54) nmol/L vs. (4.08±1.45) nmol/L] in serum of HFMD group were significantly higher than those of the healthy control group (t=-12.245, -22.895, -8.273, -12.803, -17.960, all P<0.05), while the SOD level [(57.10±10.40) kU/L vs. (70.3±14.4) kU/L] was significantly lower (t=5.457, P<0.05). (2) With the extension of treatment time for HFMD children in the two groups, S100 and NSE in cerebrospinal fluid, S100, NSE, sFas, sFasL and MDA in serum decreased, while SOD level increased.On the 3rd and 7th day after treatment, S100 (t3=3.491, t7=14.434), NSE (t3=2.920, t7=23.490) in cerebrospinal fluid, S100 (t3=5.277, t7=3.614), NSE (t3=4.652, t7=10.525), sFas (t3=6.399, t7=7.514), sFasL (t3=11.155, t7=8.804) and MDA (t3=6.348, t7=7.499) in serum of Levocarnitine group were significantly lower than those of routine group (all P<0.05), while SOD (t3=3.162, t7=-3.529) was significantly higher than that of routine group (P<0.05). (3) The relief time of neurological symptom in levocarnitine group was significantly shorter than that in the routine group [(1.23±0.65) d vs. (1.84±0.47) d], and WBC on the 3rd day after treatment [(9.14±2.93)×109/L vs. (7.12±2.58)×109/L] and the progression time of the disease [(29.74±7.85) h vs. (17.36±8.73) h] were significantly better than the those in the routine group (t=-6.178, 4.204, 8.567, all P<0.05). The critical conversion rates of Levocarnitine group and the routine group were 7.58% and 18.18%, respectively, and the difference in critical conversion rate was not statistically significant (χ2=2.316, P>0.05). (4)There was a positive correlation between S100 and sFas, sFasL, MDA in children with HFMD (r=0.373, 0.735, 0.334, P<0.05). NSE was positively correlated with sFas and sFasL (r=0.479, 0.601, all P<0.05), while SOD and S100 were negatively correlated with NSE (r=-0.425, -0.460, all P<0.05).@*Conclusions@#Levocarnitine has good curative effect on severe HFMD in children infected by enterovirus EV71, which can effectively protect the cranial nerves.The mechanism may be related to scavenging oxygen free radicals and blocking nerve cell apoptosis.
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Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris ( SAP ) and its effect on vascular endothelial function and serum levels of superoxide dismutase ( SOD ), total antioxidant capacity ( TAC ), glutathione peroxidase ( GSH-px ), malondialdehyde (MDA),and lipid peroxide( LPO) . Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group( 75 cases in each group) . Both groups received routine intervention according to the guidelines. The control group was given with intravenous drip of left carnitine(3 g／time and once a day). On basis of the control group,the observation group was treated with regular aerobic exercise therapy. After 8 weeks＇ treatment for two groups,attack frequency degree of angina pectoris,score of life quality of Seattle angina scale(SAQ),and clinical effect were compared between the two groups. And the vascular endothelial function ( plasma endothelin ( ET ) 1, nitric oxide ( NO )), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD,TAC,GSH-px, MDA and LPO) were detected. Results After 8 weeks＇treatment,frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less(( 4. 19± 0. 56) vs. ( 6. 22 ± 0. 89) time, (4. 31±0. 50) vs. (5. 25±0. 71) min),while life quality indexes SAQ score was higher,than those in the control group,and the difference was statistically significant (( 18. 44 ± 2. 30) vs. ( 12. 49 ± 1. 82) score, (56. 31±6. 62) vs. (48. 05± 5. 88) score,(14. 46 ± 1. 99) vs. ( 9. 22 ± 1. 10) score,( 21. 41 ± 2. 95)) vs. (18. 09±2. 26) score,(16. 14±2. 17) vs. (12. 05±1. 82) score,(all P＜0. 01)). The total clinical effective rate of the observation group ( 92%( 69 ／ 75)) was higher than that of the control group ( 80%( 60 ／75)),the difference was statistically significant (χ2＝4. 485,P＝0. 034). After 8 weeks′ treatment,level of ET-1,FMD of brachial artery,MDA,and LPO were lower than those in the control group(( 65. 38± 7. 91) ng／L vs. (77. 12±8. 56) ng／L,( 9. 44± 1. 34)% vs. ( 12. 55± 1. 81)%,(2. 81± 0. 43) μmol／L vs. ( 3. 90 ±0. 50) μmol／L,(3. 14±0. 44) μmol／L vs. (4. 40± 0. 63) μmol／L),while NO,SOD,TAC,GSH-px were higher than control group(( 67. 51 ± 7. 79) μmol／L vs. ( 52. 17± 6. 08) μmol／L,( 85. 25± 9. 67) U／L vs. (76. 01±8. 33) U／L,(12. 79±1. 80) kU／L vs. (9. 64±11. 05) kU／L,(117. 65±15. 03) U／L vs. (111. 76 ±14. 19) U／L),and the difference was statistically significant (all P＜0. 01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients,and improve the clinical effect,which may be related to the improvement of endothelial function and antioxidant effect.
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In this paper, a new type of preparation for treatment of initial dry eye disease, thermosensitive in situ gel, was prepared using levocarnitine as a model drug. Poloxamer 407 and poloxamer 188 were used as the gel matrix, and sodium hyaluronate and sodium carboxymethylcellulose were used as bioadhesive materials. Gelation temperature was determined by a rotor method and the prescription was optimized by central composite design-response surface methodology. The pH value, viscosity value and gelation temperature of the optimal prescription were measured. The release of the drug in vitro was examined by dialysis membrane permeation, and retention time of the thermosensitive in situ gel preparation on the rabbit's ocular surface was observed by a slit lamp microscope. The results showed that the dosage of the poloxamer 407 and poloxamer 188 were 20.81% and 3.46%, respectively, and sodium hyaluronate was 0.02%, sodium carboxymethyl cellulose was 0.10% of the optimal formulation of levocarnitine thermosensitive in situ gel. The pH value was 6.90 ± 0.06 at room temperature and the viscosity value started to rise sharply at 27 ℃ of the optimal formulation. The gelation temperature of the optimal preparation before and after dilution by simulated tear fluid were (26.37 ± 0.06) ℃ and (33.57 ± 0.21) ℃, respectively. In the first 240 min, in vitro release rate per unit area of levocarnitine thermosensitive in situ gel was lower than that of solution (P<0.05), and after 600 min, the cumulative release rate of levocarnitine thermosensitive in situ gel could reach more than 80%. The retention time of the thermosensitive in situ gel preparation on rabbit's ocular surface reached about 25 min, at least 5 times as much as that of the solution. The animal experiment was conducted following the National Institutes of Health Guidelines for the use of experimental animals, and approved by the Ethics Committee of the Experimental Animal Center of Beijing University of Chinese Medicine. The levocarnitine thermosensitive in situ gel showed good characteristics and sustained release property and significantly improved the retention time of the drug on the rabbit's ocular surface.
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Objective To discuss the efficacy of alprostadil and levocarnitine in treatment of chronic renal failure combined with heart failure.Methods Totally 80 patients with chronic renal failure complicated with heart failure were selected,and randomly divided into two groups.The control group (39 cases) was given alprostadil.The observation group (41 cases) was given alprostadil and levocarnitine.The efficacy of alprostadil and levocamitine in treatment of chronic renal failure combined with heart failure was evaluated by cardiac fimction indexes,renal function indexes,SF-36 scale score,and adverse reaction during the treatment.Results Before treatment,there was no statistical significance on CO,CI,MVO,and EF between two groups.After treatment,the CO,CI,and MVO were decreased and lower in the observation group (P ＜ 0.05).The EF was increased in the observation group and higher than that of the control group (P ＜ 0.05).The EF had no changes in the control group.Before treatment,there was no statistical significance on CysC,BUN,and SCr between two groups before treatment,without statistical significance.After treatment,CysC,BUN,and SCr were decreased in two groups and lower in the observation group (P ＜ 0.05).Before treatment,there was no statistical significance on SF-36 scores between two groups.After treatment,the physiological function,physical function,and general health were higher than those of the control group (P ＜ 0.05).There was no statistical significance on the rest of the scores.During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Alprostadil and levocarnitine had a good curative effect on chronic renal failure combined with heart failure.It could improve the heart function by reducing cardiac load,improve the renal function by increasing glomerular filtration rate and improve the quality of life with good safety.It is worthy of clinical application.
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Objective To investigate the effect of levocarnitine combined with hemodialysis on nerve conduction velocity and quality of life in patients with uremic peripheral neuropathy. Methods A total of 71 patients with uremic peripheral neuropathy were randomly divided into two groups according to the random number table. 35 patients in the control group were treated with hemodialysis. The observation group (36 cases) was treated with hemodialysis and levocarnitine. The sensory nerve conduction velocity in the median nerve, the tibial nerve and peroneal nerve, and clinical efficacy and quality of life (QOL) score in the two groups were compared. Results The rate of nerve conduction in the observation group was significantly higher than those in the control group (P<0.05). The total effective rate was 88.89% (32/36) in the observation group, which was higher than 68.57% (24/35) in the control group (P<0.05). The scores of QOL in the observation groups was higher than that in the control group (P<0.05). Conclusion The combination of levocarnitine and hemodialysis can improve the nerve conduction velocity and quality of life in patients with uremic peripheral neuropathy.
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Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.
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OBJECTIVE:To investigate the effects of levocarnitine on peripheral blood T cell subsets and inflammatory factors in diabetic patients underwent peritoneal dialysis. METHODS:A total of 100 diabetic patients underwent peritoneal dialysis in se-lected as research objects were divided into conventional therapy group and levocarnitine group according to random number table, with 50 cases in each group. Conventional therapy group received peritoneal dialysis and conventional therapy. Levocarnitine group was additionally given levocarnitine 1.0 g added into 0.9% Sodium chloride injection 20 mL intravenously,3 times a week,on the basis of conventional therapy group for 12 weeks. CD3+,CD4+,the proportion of Th1 and Th2,the contents of TNF-α,INF-γ, IL-10 and IL-4 in supernatant were all detected before and after treatment. The expression of T-bet and GATA-3 were compared be-tween 2 groups. RESULTS:After treatment,CD3+,CD4+,Th2 cells,GATA-3 expression and IL-10,IL-4 levels were significantly increased,the expression of Th1 cells,T-bet content and TNF-αand INF-γwere significantly reduced,and levcarnitine group was sig-nificantly better than conrentional therapy group,with statistically significant (P<0.05). CONCLUSIONS:Levocarnitine can im-prove inflammatory reaction and the expression of related transcription factors by promoting T cell subsets and Th1/Th2 cell subsets.
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OBJECTIVE@#To study the effect of levocarnitine (L-CN) on tissue inhibitor of metalloproteinase-1 (TIMP-1) and intercellular adhesion molecule-1 (ICAM-1) expression of rats with coronary heart disease and evaluate the protective effect of L-CN on myocardial cells.@*METHODS@#High-fat diet feeding and intraperitoneal injection of pituitrin was performed on rats in model group and CHD Model of rats was built. Rats with successful model-building were selected and divided into L-CN group and Ctrl group randomly. Rats in L-CN group were given L-CN treatment, with intraperitoneal injection of 200 mg·kg(-1)·d(-1) and successive administration for 3 d. Rats in Ctrl group were given equal volumes of normal saline. Blood was collected from carotid artery at different time and expression quantity of creatine kinase-MB (CK-MB) and Troponin Ⅰ (TnⅠ) in serum was detected. Rats in each group were put to death and were separated to obtain the myocardial tissue. Real-time PCR and Western Blotting hybridization were performed to detect the TIMP-1, ICAM-1 expression in myocardial tissue in each group. Statistical analysis was employed to explore the expression changes of TIMP-1 and ICAM-1, and ELISA test was used to analyze the expression changes of myocardial necrosis marker-CK-MB and TnⅠto learn the effect of L-CN and its myocardial protective effect.@*RESULTS@#The total cholesterol, triglyceride and blood glucose levels of rats in model group were significantly higher than that in control group, which indicated that due to high-fat diet feeding, blood lipid of rats in model group was obviously higher than that in control group. In myocardial tissue of rats in model group, TIMP-1 level significantly reduced and ICAM-1 level significantly increased (P < 0.01). In model group, after L-CN treatment, TIMP-1 level had double increase, while ICAM-1 level had 43% of decrease in L-CN group compared with Ctrl group. After L-CN intervention treatment, CK-MB and TnⅠ content in L-CN group relatively reduced compared with Ctrl group. The difference among groups was obvious (P < 0.01).@*CONCLUSIONS@#L-CN could increase the TIMP-1 expression level and inhibit the ICAM-1 expression level. L-CN has a certain myocardial protective effect.
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Objective: To investigate the effect of levocarnitine on contrast-induced nephropathy (CIN) in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). Methods: A total of 138 CAD patients with PCI were studied. Upon basic hydration, the patients were divided into 2 groups:Levocarnitine group, the patients received intravenous infusion of levocarnitine 2g at 24h before PCI and levocarnitine 2g/day after PCI for 4 days and Non-levocarnitine group. n=69 in each group. Blood levels of urea nitrogen (BUN), creatinine (Scr), creatinine clearance rate (Ccr) and the occurrence rate of CIN were compared between 2 groups at 24h and 72h after PCI. All contrast agent used in the operation was Ultravist non ionic low permeability contrast solution and the dosage was recorded during operation. Results: Compared with Non-levocarnitine group, Levocarnitine group had decreased blood levels of BUN and Scr at 24h and 72h after operation;increased post-operative Ccr, all P Conclusion: Application of levocarnitine has certain preventive and protective effect for CIN occurrence in CAD patients after PCI.
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Objective To investigate effect of levocarnitine on maintainance hemodialysis in patients with hypotension.Methods 64 cases with continuous hemodialysis hypotension were randomly divided into control group and treatment group, 32 cases in each group.Patients in the control group were treated with erythropoietin treatment after regular hemodialysis, and the treatment group based on the control group with levocarnitine.Blood pressure, hemoglobin, urea clearance rate, hypotension and changes of C-reactive protein (CRP), arteriovenous fistula occlusion and cardiovascular events incidence were compared after the treatment.Results Compared with before treatment, the incidence of two groups of blood pressure and hemoglobin levels were significantly increased ( P <0.05 ) and CRP levels decreased ( P <0.05 ) , hypotension, arteriovenous fistula occlusion and cardiovascular events rate were decreased (P<0.05); compared with the control group, systolic blood pressure and minimum systolic blood pressure and hemoglobin levels of treatment group were higher (P<0.05) and CRP levels were lower (P<0.05), the incidence of hypotension, arteriovenous fistula occlusion and cardiovascular events were lower (P<0.05), the clinical curative effect was higher (P<0.05).Conclusion Levocarnitine can effectively reduce the occurrence of hypotension in hemodialysis patients continuously, with good clinical efficacy and safety.
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Objective: To study the effect of levocarnitine (L-CN) on tissue inhibitor of metalloproteinase-1 (TIMP-1) and intercellular adhesion molecule-1 (ICAM-1) expression of rats with coronary heart disease and evaluate the protective effect of L-CN on myocardial cells. Methods: High-fat diet feeding and intraperitoneal injection of pituitrin was performed on rats in model group and CHD Model of rats was built. Rats with successful model-building were selected and divided into L-CN group and Ctrl group randomly. Rats in L-CN group were given L-CN treatment, with intraperitoneal injection of 200 mg·kg
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Objective To explore the impact of levocarnitine on microinflammatory state in hemodialysis patients with diabetic nephropathy(DN) .Methods Sixty outpatients and inpatients with DN in the Second Aid Hospital of Xinjiang Uygur Autonomous Region from January 2010 to December 2012 were selected as the research subjects according to the inclusion and exclusion stand‐ards and randomly divided into DN conventional treatment group (conventional treatment group ,n=30) and levocarnitine treatment observation group (levocarnitine treatment group ,n=30) .Contemporaneous 20 individuals undergoing the healthy physical exami‐nation were selected as the healthy control group ,DN was excluded .The two treatment groups were given the insulin therapy ,on the basis of the routine therapy the levocarnitine treatment group was added with levocarnitine oral solution (2 g daily) .The treat‐ment in both groups lasted for 3 weeks .The efficacy was observed and the indicators were detected before and after treatment ,in‐cluding interleukin‐6 (IL‐6) ,C‐reactive protein (CRP) ,tumor necrosis factor‐α(TNF‐α) ,urinary albumin excretion rate (UAER) , serum albumin (Alb) ,hemoglobin (Hb) ,endogenous creatinine clearance rate (Scr) ,total cholesterol (TG) and triglycerides (TC) .The above indicators in the healthy control group were detected in physical examination .Results The CRP ,IL‐6 ,TNF‐αlev‐els after treatment in the conventional treatment group and levocarnitine treatment group were higher than those in the healthy con‐trol group .The CRP ,IL‐6 and TNF‐αlevels after treatment in the levocarnitine treatment group were lower than those in the con‐ventional treatment group .The above 3 inflammatory cytokines levels after treatment in the levocarnitine treatment group were low‐er than before treatment .The TC ,TG and Ccr levels after treatment in the levocarnitine treatment group were lower than those in the conventional treatment group ,while the Alb and Hb levels were higher than those in the conventional treatment group ,the differences were statistically significant (P<0 .05) .Conclusion The microinflammation level after levocarnitine treatment in main‐tenance dialysis patients with DN is alleviated to some extent ,the renal function and nutritional status have certain improvement .
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Objective To investigate the effects of levocarnitine on pregnancy outcome of the patients with obstructive azoospermia treated with intracytoplasmic sperm injection ( ICSI ) . Methods A total of 74 patients with obstructive azoospermatism treated with ICSI randomly divided into 2 groups:treatment group( n=38) , taking levocarnitine before treatment with ICSI 1 g twice a day for three months;control group( n=36) , taking vitamine E before treatment with ICSI 0.1 g twice a day time for three months.tumor necrosis factor-α(TNF-α), reactive oxygen species(ROS) level, epididymal sperm motility and morphology in epididymal fluid of the two groups were determined before and after treatments. The number of matured oocytes, fertilization, and embryos of adequate quality, the rate of fertilization and embryo of adequate quality, and pregnancy rates after PESA-ICSI were compared between the two groups. Results TNF-α in epididymal fluid before and after the treatment was (5.39±2.28)and(4.05±2.14)ng.mL-1 in the treatment group(P0.05).After PESA-ICSI, the number and percentage of high quality embryo in the treatment group were significantly higher than those of the control group(P<0.05). Conclusion Levocarnitine can down-regulate epididymal TNF-α and ROS in patients with obstructive azoospermatism, thereby improve the environment of the epididymis and elevate the quality of sperm and ICSI pregnancy outcome.
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Objective:To explore the effects of levocarnitine adjunctive therapy on serum nutritional index and inflammatory factor level in maintenance hemodialysis patients. Methods:Totally 62 patients with hemodialysis were randomly divided into the observation group and the control group with 31 cases in each. The observation group was treated with 1g levocarnitine injection with intravenous in-jection after the dialysis, and the control group was treated with 0. 9% physiological saline injection with the same volume after the di-alysis. After 3-month treatment, the nutritional indices including Hb, Alb, TC, TG, LDL-C and HDL-C and the change in inflamma-tory factors including C-reactive protein (CRP), IL-6, IL-8 and TNF-α of the patients in the two groups were studied and compared. Results:After the treatment, the level of Hb and Alb was improved in the observation group (P0. 05). All of the indices showed no significant change in the control group (P>0. 05). After the treatment, the level of Hb and Alb in the observation group was higher than that in the control group (P0. 05). All of the indices in the observation group was better than those in the control group (P<0. 05). Conclusion:Levocarnitine used in the treatment of patients with hemodialysis can effectively improve the nutritional status and inflammatory factors level without obvious effects on lipid metabolism, which is very important for the reduction of complication and the improvement of life quality, and worthy of clinical promotion.
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Objective Non-alcoholic fatty liver ( NAFL) is a metabolic disease and levocarnitine can be used to improve the energy metabolism of the patient .This study aimed to evaluate the clinical efficacy of levocarnitine in the treatment of NAFL . Methods We retrospectively analyzed 85 cases of NAFL treated by lifestyle intervention (control group, n=40) or by lifestyle intervention +levo-carnitine medication (medication group, n=45).In addition to lifestyle intervention, the patients in the medication group received oral levocarnitine at 10 mL tid for 4 weeks followed by a reduced dose of 10 mL bid for another 8 weeks. Results Twelve weeks after treat-ment, 37 cases (82.2%) in the medication group showed remarkable improvement and the other 8 failed to respond.In the control group, 23 cases (57.5%) were improved and 17 cases remained unimproved .There were statistically significant differences in the rate of therapeutic effectiveness between the two groups of patients (P<0.01).No adverse effects were observed during the levocarnitine medi-cation. Conclusion Lifestyle intervention +levocarnitine medication can improve NAFL .
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Objective:To observe and study the short-term efficacy of levocarnitine combined with trimetazidine in the treatment of elderly heart failure of ischemic cardiomyopathy. Methods:Totally 106 elderly patients with ischemic cardiomyopathy and heart failure were randomly divided into the observation group and the control group with 53 ones in each. All the patients were given anti-platelet, anti-myocardial ischemia and lipid-lowering therapy as well as the conventional therapy on myocardial ischemia. The control group was treated with trimetazidine,20mg,po,tid,while the observation group was additionally treated with 2g levocarnitine with 0. 9% sodium chloride injections,100ml,ivd,qd. The treatment course was 4 weeks. The improvement of heart function and the changes in cardiac function indices( including LVEDD,LVESD and LVEF)and cardiac ischemia markers( CKMB,TüI and BüP)before and after the treatment were compared between the two groups. The incidence of adverse drug reactions,the rate of re-hospitalization and mortality in the two groups were also compared. Results:The significant efficiency and total effective rate in the observation group were much higher than those in the control group(P0. 05). Conclusion:Levocarnitine combined with trimetazidine on the basis of the conditional therapy in the treatment of elderly patients with ischemic cardiomyopathy and heart failure can effectively improve heart function with better clinical efficacy,which is worthy of promo-tion in clinic.