左卡尼汀联合辅酶Q10治疗重症慢性心力衰竭的临床疗效及安全性评价

Clinical efficacy and safety of L-carnitine and coenzyme Q10 in treatment of severe chronic heart failure

目的评价左卡尼汀联合辅酶Q10治疗慢性重症心力衰竭的临床疗效及安全性。方法将196名慢性心力衰竭心功能Ⅲ~Ⅳ级患者按性别年龄配对后,将每个对子随机分为试验组和对照组,每组各98例。对照组予以酒石酸美托洛尔,每次100 mg,bid＋氯沙坦50 mg,qd＋螺内酯40 mg,bid等常规抗心力衰竭治疗;试验组在对照组的基础上,加用左卡尼汀20 mg·kg-1,bid＋辅酶Q10,每次10 mg,tid。2组患者疗程均为7 d。比较2组患者治疗后心功能改善情况以及不良反应发生率。结果试验组的总有效率达89.80%显著高于对照组63.27%（P〈0.05）。治疗后,试验组的C反应蛋白含量和B型尿钠肽检测水平显著低于对照组（P〈0.05）,试验组的6 min步行距离明显远于对照组（P〈0.05）,试验组的左心室射血分数显著高于对照组（P〈0.05）,左心室舒张期末径和左心室收缩末期内径明显低于对照组（P〈0.05）。2组患者不良反应发生率比较差异无统计学意义（P〉0.05）。结论左卡尼汀联合辅酶Q10能显著提高重症慢性心力衰竭治疗的临床疗效,且不增加不良反应的发生率。

Objective To evaluate the clinical effect and safety of L - carnitine and coenzyme Q10 on the treatment of chronic heart failure. Methods One hundred ninety -six patients with chronic heart failure cardiac III - 1V level were paired by age and gender, and each pair were randomly divided into experimental group and the control group, every group has 98 patients. The control group was treated with metoprolol 100 mg, bid ＋ chlorine 50 mg qd ＋ spironolactone 40 mg bid conventional heart failure treatment. The experimental group was added with L - carni- time （20 mg ~ kg-1 ,bid） and coenzyme QlO （10 mg tid） on the basis of conventional treatment. After treatment, the improvement of cardiac function and incidence of adverse drug reactions between the two groups were compared. Results The total effective rate of treatment group （89.80%） is significantly higher than that in control group 63.27% （P 〈0. 05）. After treatment, the C reactive protein content and the brain natriuretic peptide （BNP） level of experimental group were signifi- cantly lower than those in control group （ P 〈 0. 05）. 6 rain walking dis- tance of patients in experimental group is longer than that in control group. The left ventricular ejection fraction （LVEF） of treatment group was significantly higher than that in control group and the left ventricular diastolic diameter （LVEDD） and left ventricular end systolic diameter （LVESD） significantly lower than those of control group. The adverse reactions between the two groups have no signifi improve the treatment cant difference （P 〉 0. 05）. Conclusion L- carnitine combined coenzyme Q10 can significantly effect of severe chronic heart failure without increasing of the incidence of adverse drug reactions.