左旋卡尼汀对老年腹部术后心力衰竭患者的疗效分析

Clinical effect of L-carnitine on postoperative congestive heart failure of elderly patients following abdominal operation

目的观察左旋卡尼汀治疗老年腹部术后心力衰竭患者的临床疗效。方法选择腹部手术后并发心力衰竭老年患者57例,随机分为2组,对照组25例予洋地黄、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂等常规药物治疗,卡尼汀组32例,在常规治疗的基础上加用国产左旋卡尼汀5.0g治疗15d。结果两组治疗后临床症状和射血分数(EF)较治疗前均有改善,但卡尼汀组心功能改善的临床显效率(44%)和总有效率(94%)均较对照组(36%和80%)显著提高(分别为P<0.05和P<0.01),治疗后卡尼汀组EF(0.52±0.03)与对照组(0.50±0.04)和治疗前(0.48±0.05)相比,差别均有显著性意义(均P<0.01),且无药物不良反应。结论左旋卡尼汀辅助治疗老年腹部术后心力衰竭患者有较好疗效。

AIM To evaluate the clinical effect of L-carnitine （L-CN） on postoperative congestive heart failure of elderly patients who had undergone abdominal operation. METHODS Fifty-seven elderly patients with postoperative congestive heart failure following abdominal operation were randomly divided into control group receiving conventional treatment （digitalis, diuretics, vasodilator, ACEI） and L-CN group （conventional treatment combined with L-CN）. The treatment course was 15 days. RESULTS There was some difference in heart function changes in two groups before and after treatment. But the effective rate in improving heart function was 94% in L- CN group and 80% in control group （P 〈0.01 ）. Significant difference in left ventricular ejecting fraction was found between the two groups after treatment （P 〈 0.05）. No adverse effects of the drug were observed. CONCLUSION L-CN combined with conventional treatment effectively improves the heart function when used to treat the postoperative congestive heart failure of elderly patients who have undergone abdominal operation.