参麦注射液联合左卡尼汀治疗老年缺血性心肌病心力衰竭疗效观察

Clinical Effects of Shenmai Injection Combined with Levocarnitine in Treatment of Ischemic Cardiomyopathy Heart Failure in Elderly

目的观察参麦注射液联合左卡尼汀治疗老年缺血性心肌病心力衰竭的短期疗效。方法选择我院收治老年缺血性心肌病心力衰竭患者68例,随机分为常规组和观察组各34例,两组患者均接受调脂、抗血小板和抗心肌缺血的基础治疗,应用治疗心力衰竭的常规药物(利尿剂、血管紧张素转换酶抑制剂、醛固酮拮抗剂、地高辛等),观察组在此基础上给予参麦注射液50ml加入5%葡萄糖注射液200ml中静脉滴注,2次/d,左卡尼汀2g加入0.9%氯化钠溶液20ml静脉注射,1次/d,疗程均为2周。两组患者治疗前及治疗后进行超声心动图检查,测定左室射血分数(LVEF)、左室短径缩短率(LVFS)、每搏量(SV)及心排出量(CO);查血、尿常规,电解质,肝、肾功能。结果两组患者心功能疗效间差异有统计学意义(u=2.03,P<0.05)。两组患者治疗前LVEF、FS、SV、CO间差异无统计学意义(P>0.05),两组患者治疗后LVEF、FS、SV、CO间差异均有统计学意义(P<0.05)。两组治疗后复查血、尿常规、电解质及肝、肾功能均未见异常。结论参麦注射液联合左卡尼汀治疗老年缺血性心肌病心力衰竭短期疗效显著,且无明显不良反应。

Objective To study the clinical effects of Shenmai Injection combined with levocarnitine in treatment of ischemic cardiomyopathy heart failure （ICHF） in elderly. Methods Sixty - eight elderly patients with ICHF were randomly divided into routine group （ n = 34） and observation group （ n = 34）. Both groups received such basic treatment as lipid - lowering, anti- platelet and anti- myocardial ischemia, etc. , using conventional drugs for heart failure （diuretics, angiotensinconverting enzyme inhibitors, aldosterone antagonist and digoxin etc. ） ; besides it, observation group were treated with Sbenmai Injection in a dosage of 50 ml in 200 ml intravenous drip of 5% glucose solution, twice daily, and with 2 g dosage of levocarnitine intravenous injection in 0. 9% saline solution, once daily. Both courses were two weeks. Echocardiography was performed on both groups to determine left ventric eject fraction （LVEF）, fractional shortening （FS） of left ventricular, stroke volume （SV）, and cardiac output （CO） before and after treatment. Routine blood and urine, blood electrolyte, liver and kidney function were also detected. Results There was significant difference in curative effect of heart function between two groups （ u = 2. 03, P 〈0. 05）. No significant difference was noted in LVEF, FS, SV and CO between two groups before treatment （ P 〉 0. 05 ）, but after treatment there was （ P 〈 0.05）. Both groups were normal with the recheck of routine blood and urine, blood electrolyte, liver and kidney function after treatment. Conclusion Short - term clinical effects of Sbenmai Injection combined with levocarnitine is notable in treatment of elderly ischemic cardiomyopathy heart failure, without any obvious adverse reactions.