叶酸和维生素B_(12)辅助治疗老年慢性心力衰竭120例临床观察

Clinical efficacy After Adjuvant Treated Used Folic acid and vitamin B12 in elderly patients with chronic heart failure

目的:观察叶酸和维生素B_(12)辅助治疗老年慢性心力衰竭后(Chronic Heart Failure,CHF)患者临床疗效及治疗前后心脏彩超、血脂、炎性因子、氧化和抗氧化能力的变化。方法:240例老年CHF患者随机分为对照组和治疗组,每组为120例,对照组采用强心、利尿、扩血管等常规治疗;观察组在对照组给药基础上加用叶酸和维生素B12口服治疗,治疗时间为12周,12周后比较治疗前后超声心动图、血脂、炎性因子、氧化和抗氧化能力的变化特点。结果:治疗后观察组总有效率明显高于对照组(P<0.05);两组治疗后LA、LVDd、LVDs、ISA、CHOL、TG、LDL-C、MDA、IL-1α、IL-1β、ANG-II、ET-1以及TNF-α明显高于治疗前(P<0.05),EF、HDL-C、GSH、SOD以及T-AOC明显高于治疗前(P<0.05);治疗组治疗后,EF、GSH、IL-1α、IL-1β、ANG-II、ET-1以及TNF-α明显高于对照组治疗后(P<0.05),MDA明显低于对照组治疗后(P<0.05),其它检验指标治疗组治疗后与对照组治疗后相比没有差异。结论:在西医常规治疗的基础上给予老年CHF患者补充叶酸和维生素B12辅助治疗CHF,能显著改善老年CHF患者心功能,降低炎症反应,提高抗氧化能力,值得临床推广应用。

Objective To evaluate the clinical efficacy of folic acid and vitamin B12 adjuvant treatment elderly patients with chronic heart failure （CHF） patients, analyses blood lipids, inflammatory factors, oxidation and antioxidant capacity before and after treatment. Methods 240 cases elderly CHF patients were randomly divided into control and treatment groups, control group given a strong heart, diuretic, vasodilator and other conventional treatment ; observation group on the basis of the control group use folic acid and vitamin B12 oral treatment, the treatment time was 12 weeks, before and after the use of echocardiography changes in the characteristics of patients while comparing lipids, inflammatory factors, oxidation and antioxidant capacity after treatmen. Results After treatment, the total efficiency of the observation group （90. 00% ） was significantly higher （80. 17% ）, P 〈 0. 05 ; post - treatment group and the post -control group LA, LVDd, LVDs, ISA, CHOL, TG, LDL-C, MDA, IL- 1α, IL- 1β, ANG-II, ET- 1 and TNF-α was significantly higher than the previous corresponding group （ P 〈 0. 05 ）, EF, HDL - C, GSH, SOD and T - AOC obvious higher than the corresponding groups; post-treatment group, EF, GSH, IL- 1α, IL- 1β, ANG-II, ET-1 and TNF-α significantly higher after treatment, MDA was significantly lower, other test indicators the treatment group of after treament compared to control groups of after treament are not statistically significant. Conclusion given folic acid and vitamin B12 in elderly CHF patients in the adjuvant treatment on the basis of conventional medicine can improve heart function in elderly patients with CHF, reduce symptoms, improve clinical effi- cacy, worthy of clinical use.