Clinical Research Into The Protective Efficacy Of L-Carnitine Against Hypoxic-Ischemic Encephalopathy

Objectives: L-Carnitine, a substance that can be produced in our own human body,mainly exists in the heart and skeletal muscles. As an agent to adjust the fat metabolism,it assists the long-chain fatty acids with its entry into the plastosome and accelerates the oxidization of the fatty acid β-, and finally it benefits the further decomposition of fat.Besides, it can adjust the use of sugar and the supply of energy to some extent. Some research shows that L-carnitine can adjust the percentage difference between acetyl coenzyme A and and coenzyme A and activate the pyruvate dehydrogenase complex. And also it can increase the reactivity of the antioxidant enzyme, scavenge the excess oxygen free radicals that result from ischemia reperfusion, protect the structure and function of plastosome, depress the cell death, etc. In recent years after a quantity of researches,experts from home and abroad find that L-Carnitine is an effective cerebral protection agent, which protects the organism from the hypoxic ischemic injury and apparently from the injury caused by the ischemia reperfusion. Researchers involved in the foreign pediatrician field mostly focus on the myocardial injury among the researches concerning the protection of L-Carnitine against HIE, but nobody has studied how L-Carnitine can be clinically applied to remedy the hypoxic ischemic cerebral injury. This research mainly aims to explore whether L-Carnitine can be clinically applied to protect the newborns from the hypoxic ischemic cerebral injury in the expectation of supplying a reference for remedying HIE for newborns.Methods: Pick sixty newborn sufferers from Yan’an University Affiliated Hospital, who were born from January 2015 and December 2015. All baby sufferers satisfy the following: transferred to the Department of pediatrics within twenty-four hours after delivery; the gestational age is from thirty-seven weeks to forty-two weeks; the weight is not less than 2500g; it complies with the 2005 HIE Diagnosis Standard for Newborns;all the infant suffers satisfy the clarification of medium HIE. Such sixty sufferers are randomly divided into Observation Group(n=30) and Contrast Group(n=30). Both the Observation Group and Contrast Group are given the conventional treatment inclusive of“Three Maintenance Therapies and Three Symptomatic Therapies”. Besides the conventional treatment, Observation Group is also given L-Carnitine(0.05g/kg.d) for auxilliary treatment within 6-18 hours after their birth while Contrast Group is only given conventional treatment. The CK-MB, NSE and S100 B are detected for such two groups of sufferers within twenty-four hours after their birth. CK-MB is detected again after the treatment for three days while both NSE and S100 B are detected again after the treatment for seven days. The software spass19.0 is used to compare the biochemical indices at different stages in order to analyze whether L-Carnitine can protect the newborns from HIE.Results:Firstly, after the treatment for three days, the level of CK-MB for both Observation Group and Contrast Group apparently decreases, showing the statistical significance( P<0.05). And the level of decrease has apparent difference between these two groups,showing statistical significance(P<0.05).Secondly, after the treatment for seven days, the level of NSE for both of these two groups apparently decrease, showing statistical significance(P<0.001). And the level of decrease has apparent difference, showing statistical significance(P<0.001).Thirdly,after the treatment for seven days, the level of S100 B for both of these two groups does not change apparently, not showing the statistical significance(P >0.05).And the change does not have apparent difference, not showing the statistical significance(P>0.05).Conclusions:Firstly, the detection of NSE, S100 B and CK-MB has positive significance in the early diagnosis of HIE for newborns.Secondly, S100 B can be used as a reference indicator for diagnosing HIE for newborns at the acute stage, but it is not advised to use it as the only basis for deciding the therapeutic efficacy at an early stage.Thirdly, L-Carnitine can remedy the hypoxic ischemic cerebral injury. It has positive clinical significance in protecting the hypoxic ischemic cerebrum by the L-Carnitine intervention in combination with detecting the NSE, S100, and CK-MB.