环磷酸腺苷葡胺治疗老年慢性充血性心力衰竭临床观察

Clinical Observation of Elderly Patients with Chronic Heart Failure Treatment by Meglumine Cyclic Adenosine Monophosphate

目的观察环磷酸腺苷葡胺(MCA)治疗老年慢性充血性心力衰竭(CHF)的临床效果。方法将46例CHF患者随意分为两组:对照组(n=21)采用常规抗心衰治疗;治疗组(n=25)在常规抗心力衰竭治疗的基础上,将MCA120mg加入5%葡萄糖250ml静脉滴注,每日1次,14d为1疗程。观察治疗前、后两组左室舒张末期内径(LVDd)、左室射血分数(LVEF)、心输出量(CO)、外周血中心钠肽(BNP)和C反应蛋白(CRP)水平及临床效果。结果两组患者治疗14d后,LVEF、CO均有所上升,LVDd和外周血BNP、CRP水平明显下降(P<0.05),而治疗组较对照组LVEF、CO、LVDd和外周血CRP、BNP改善更为明显(P<0.05);两组心功能较治疗前均有所改善,而治疗组总有效率可达96%,明显高于对照组的85.7%,其差异有统计学意义(P<0.05)。结论 MCA治疗CHF安全、有效,可有效改善心功能、提高生活质量,值得临床上推广。

Objective For the elderly patients with congestive heart failure（CHF）,to study the clinical results of meglumine cyclic adenosine monophosphate（MCA）.Methods Totally 46 patients with CHF were randomly divided into two groups： control group（n=21）,using conventional therapy;treatment group（n=25）,based on the anti-heart failure treatment in general,120mg MCA infused in 250ml 5% glucose once a day,used for 2 weeks.Observed left ventricular end diastolic diameter（LVDd）,left ventricular ejection fraction（LVEF）,cardiac output（CO）,blood centers natriuretic peptide（BNP） and C-reactive protein（CRP） levels and clinical effect before and after treatment both groups.Results The LVEF,CO increased significantly after treatment in the two groups than before,LVDd and peripheral blood CRP,BNP levels were significantly decreased（P0.05）,LVEF,CO,LVDd,and blood CRP,BNP improved more significantly（P0.05） in the treatment group than that in the control group.After 2 weeks of treatment,heart function had improved in both groups,total effective rate was 96% in treatment group,which was higher than the 85.7 % of control group,and the differences were statistically significant（P0.05）.Conclusion For the patients with CHF,the MCA treatment is safe and effective,may improve cardiac function and quality of life,so it is worthy of clinical practice.