左卡尼汀对心衰患者心功能和内分泌的影响

Influence of levocarnitine on heart function and endocrine among patients with heart faliure

目的 观察左卡尼汀治疗老年慢性心力衰竭（心衰）的疗效,探讨其对患者心功能和内分泌的影响.方法 120例老年慢性心衰患者按随机原则分为对照组和观察组,每组60例.对照组给予常规抗心衰药物治疗,观察组在对照组用药的基础上每日一次给予3 g左卡尼汀加250ml生理盐水静脉滴注,15d后观察两组疗效.结果 观察组患者总有效率为95.0％,显著高于对照组（83.3％）,差异有统计学意义（x2=4.227,P＜0.05）.观察组在治疗后的左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）和左心室收缩末容量（LVESV）指标均显著低于对照组,差异有统计学意义（t=2.256、2.335、2.277,P＜0.05）,左室射血分数（LVEF）指标显著高于对照组,差异有统计学意义（t=2.364,P＜0.05）.治疗后观察组血清钠尿肽（NT-pro-BNP）、肌酐和胱抑素C值较对照组有明显下降,差异有统计学意义（t=2.339、2.289、2.315,P＜0.05）.结论 左卡尼汀能够显著改善患者的心功能,降低血清NT-pro-BNP、肌酐和胱抑素C的水平,且安全有效,值得临床推广应用.

Objective To observe the efficacy of levocarnitine in treating elderly patients with chronic heart failure and to explore its impact on cardiac function and endocrine.Methods 120 elderly patients with chronic heart failure were randomly divided into observation and control groups,with 60 cases of each.Patients in the control group were given conventional anti-heart failure drugs,and those in the observation group were given 3 g levocamitine within 250 ml normal saline for intravenous infusion added to what had been given to the control group.Efficacy of the two groups was observed after 15 days.Results The total effective rate in observation group was 95.0%,significantly higher than in the control group （83.3%）,with statistically significant difference （x2=4.227,P〈0.05）.After treatment,indicators as LVEDD,LVESD and LVESV in the observation group were significantly lower than those in the control group,with statistically significant differences （t=2.256,2.335,2.277,P〈0.05）.The LVEF values were significantly higher than in the control group after treatment,with statistically significant difference （t=2.364,P〈0.05）.Serum NT-pro-BNP,creatinine and cystatin C values in the observation group after treatment appeared significant reduction,when compared to the control group,and the difference was statistically significant （t=2.339,2.289,2.315,P〈0.05）.Conclusion Levocarnitine could significantly improve the cardiac function,and reduce the levels of serum NT-pro-BNP,creatinine and cystatin C.Our results suggested that it was worthwhile to promote large-scale clinical trials of this kind.