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Objective To study the protective effect of L-carnitine on hypoxia / ischemia - reperfusion myocardial cells, and to explore its mechanism. The method of study is divided into two parts. The first part of primary cultured SD neonatal rat cardiomyocytes establish hypoxia - reoxygenation model to study the protective effect and mechanism of L-carnitine on hypoxia - reoxygenation, the culture of SD neonatal rat cardiomyocytes were randomly divided levocarnitine treatment group and the control group, hypoxia group, hypoxia group and levocarnitine treatment group for the three groups were hypoxia 2h, and the the reoxygenation 2h, which is given before hypoxia Levocarnitine, the survival rate of myocardial cells before and after comparison hypoxia, the culture medium in cardiac enzymes, superoxide dismutase (SOD) levels and the ultrastructure of the cells were observed. The second part of to explore newborn levocarnitine different complementary approaches of differences in efficacy and supplement levocarnitine associated with abnormal levels of serum creatine kinase isoenzyme (CK-MB) neonatal intervention. Selected mainly due to ischemic / hypoxic diseases caused by abnormal neonates 100 cases of CK-MB and CK-MB the normal General newborns 20 cases, the former (the experimental group) were randomly divided into 5 groups of 20 cases and be different intervention programs : intravenous small dose levocarnitine treatment group (low-dose group) I levocarnitine injection 0.1g / (kg × d) intravenous infusion, 1 / d; levocarnitine intravenous high-dose treatment group ( intravenous dose group) I levocarnitine injection 0.15g / (kg × d) 1 / d; levocarnitine and fructose treatment group (the composite drug group) I levocarnitine injection 0.1g / (kg × d) intravenous injection FDP 0.16g / (kg × d) intravenous infusion, 1 / d; fructose treatment group to the FDP injection 0.16 g / (kg × d) intravenous infusion, 1 / d; the oral Levocarnitine treatment group (oral group) I levocarnitine oral solution 0.1g / (kg × d) oral, 1 / d. Latter be conventional symptomatic and supportive treatment (control group). Treatment 7d for a course of treatment. Detection of each group of children born after 1d (before treatment), medication 3d and 7d serum CK-MB level; each group of children (in addition to the composite drug group) heel blood filter paper samples were collected at the same point in time, using tandem mass spectrometry method for the determination of children with plasma free carnitine levels. The results of the first part: because of the time constraints and laboratory bacterial contamination only completed neonatal rat cardiomyocytes in vitro primary culture, failed to establish the hypoxia - reoxygenation model and give the neonatal rat cardiomyocytes levocarnitine intervention. Part II: 1, serum CK-MB in the steady decline in the rate of 1 week, respectively (the low-dose group 75.0%, 85.0% of the high-dose group, 45.0% of the fructose group the composite drug group 85.0% in the control group 85.0% of the oral group 75.0%) (χ 2 = 6.67, P lt; 0.05), the cure rate of children in each experimental group (95.0% of the low-dose group, 95.0% of the high-dose group, 75.0% of the fructose group composite drug group 95.0% in the oral group, 90.0%) (χ2 = 1.29, P gt; 0.05). 2, after birth, at 7d, each experimental group of serum CK-MB than 1d decline in the extent of the difference was not statistically significant, the value for the (low-dose group, 97 ± 43, the high-dose group 87 ± 86, fructose group 70 ± 63 the composite drug group 83 ± 75 oral group 54 ± 42 units.%) (P gt; 0.05). The control group of serum CK-MB decreased degree (8 ± 7)%, the difference was statistically significant (P lt; 0.05) compared with the experimental group. 3, after birth, at 7d, the highest levels of fructose concentrations of serum CK-MB, and other groups difference was statistically significant, the values ??were (low-dose group, 34.25 ± 14.2, the high-dose group 34.95 ± 18.6, fructose 57.21 ± 40.1, composite drug group 37.05 ± 13.7, control group, 33.7 ± 10.9, oral group 37.11 ± 16.1, unit U / L) (P LT; 0.05). 4, whether large doses or small doses of intravenous supplement L-carnitine, all can make children with plasma free carnitine levels continued to rise in 7d, and adverse drug reactions did not occur in the high-dose supplementation, oral supplement levocarnitine The slow decline in plasma free carnitine levels. Before and after birth more than three groups of children with supplementary levocarnitine 3d and 7d plasma free carnitine levels, respectively, for the (low-dose group, 39.85 ± 11.5,102.55 ± 65.64,189.9 ± 50.9, the high-dose group 43.2 ± 13.8,162.85 ± 99.6,197.45 ± 107.3, the oral group 36.33 ± 7.2,34.51 ± 7.5,29.11 ± 5.9, units μmol / L) (P lt; 0.05). 5, the control group and the fructose group of children born after 1 week plasma free carnitine levels also continued to significantly decline (fructose group 40.85 ± 15.4,38.14 ± 18.1,27.57 ± 9.7, control group 29.11 ± 11.6,23.75 ± 7.2,17.93 ± 4.2, Unit μmol / L), fructose group decreased the degree of (32 ± 17)% of the control group (31 ± 19)%, then the oral group were plasma free carnitine levels also slow decline after birth small, but a drop of over the previous two groups (24 ± 16)%, above decline in the degree of difference between the three groups was statistically significant (P lt; 0.05). 6 changes and changes of serum CK-MB levels of plasma free carnitine levels positively correlated with a correlation coefficient of 0.34. Conclusion 1, does not give the supplement L-carnitine in children 1 week after birth, plasma free carnitine levels decreased, intravenous supplement levocarnitine can effectively improve the the neonatal plasma free carnitine levels. The oral supplement levocarnitine can reduce the extent of children with plasma free carnitine levels decline. 2, application of L-carnitine can effectively reduce neonatal abnormal serum CK-MB level and fructose significantly more effective than application. Changes in plasma free carnitine levels and changes of serum CK-MB levels positively correlated with a correlation coefficient of 0.34.
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