硫辛酸在糖尿病合并心力衰竭患者中应用的临床观察

Effect of Alpha lipoic acid on chronic heart failure in diabetes mellitus

目的探讨硫辛酸治疗糖尿病合并心衰患者的疗效及其作用机制。方法将86例T2DM合并心力衰竭(chronic heart failure,CHF)患者分为治疗组和对照组,分别为47例和39例,两组均采用常规抗心衰、降糖治疗;治疗组加用硫辛酸。观察两组治疗前后临床疗效、心功能分级、明尼苏达心衰生活质量评分、超声心动图检测及丙二醛、高敏C反应蛋白(hs-CRP)变化。结果两组治疗后心功能分级、超声心动图检测指标、MDA及hs-CRP均明显降低,但治疗组改善较为明显(P<0.05)。与对照组比较,治疗组明尼苏达心衰生活质量评分明显提高(P<0.05)。结论硫辛酸可以通过降低炎症反应、氧化应激水平来改善自主神经病变及T2DM合并心衰患者的心功能,提高其生活质量评分。

Objective To investigate the effect and mechanism of Alpha lipoic acid（ALA） on chronic heart failure（CHF） in diabetes mellitus（DM）.Methods 86 patients were divided randomly into treatment group of 43 cases（received conventional therapy ＋ ALA） and control group of 39 cases（received conventional therapy）.Ultrasonic cardiogram,grading of cardiac function,clinical effect,Minnesota living with heart failure questionnaire score,MDA and hs-CRP were respectively measured in all patients before and after treatment.Results At the end of treatment,the grading of cardiac function,ultrasonic cardiogram,MDA,hs-CRP in two groups increased obviously,while the treatment group improved significantly（P 0.05）.Compared with the control group,Minnesota living with heart failure questionnaire score in the treatment group increased obviously（P 0.05）.Conclusion Alpha lipoic acid can decrease the inflammatory response,oxidatie stress reaction to improve the autonomic lesions and the heart function of T2DM patients with heart failure and their score of quality life.