血必净联合左卡尼汀治疗中老年患者感染性心内膜炎的疗效观察

Effect of Xuebijing injection combined with levocarnitine on treatment of middle aged patients with infectious endocarditis

目的探讨血必净联合左卡尼汀治疗中老年患者感染性心内膜炎的临床疗效。方法选取2015年9月-2016年10月医院治疗的中老年感染性心内膜炎患者90例作为研究对象,分为对照组和试验组,各45例,对照组给予血必净静脉滴注治疗,试验组患者在对照组治疗基础上给予左卡尼汀静脉滴注治疗,比较两组患者治疗干预前、后的白细胞计数、血清肿瘤坏死因子(TNF-α)指标水平、心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、左心射血分数(LVEF)以及心率(HR)],并比较两组患者治疗疗效及并发症发生率。结果治疗前,两组患者的白细胞计数、TNF-α等体内炎性因子指标水平差异无统计学意义;治疗干预后,两组患者白细胞计数及TNF-α水平都有改善,且相比对照组,试验组患者炎症因子改善情况优于对照组(P<0.05);治疗前,两组患者LVESD、LVEDV、LVEF及HR等心功能指标差异无统计学意义;治疗后,两组LVESD、LVEDV、LVEF及HR指标均有改善,且试验组优于对照组(P<0.05);试验组治疗总有效率为95.56%,优于对照组(P<0.05);试验组治疗后感染并发症发生率低于对照组(P<0.05)。结论血必净联合左卡尼汀治疗中老年感染性心内膜炎能够有效改善心功能指标水平,预防和减少体内炎症反应,降低心力衰竭、心肌梗死等并发症,治疗价值显著,值得应用推广。

OBJECTIVE To explore the clinical effect of Xuebijing injection combined with levocarnitine on treatment of middle aged patients with infectious endocarditis.METHODS A total of 90 middle aged patients with infectious endocarditis who were treated in the hospital from Sep 2015 to Oct 2016 were recruited as the study objects and divided into the control group and the experimental group,with 45 cases in each group.The control group was given intravenous drip of Xuebijing,while the experimental group was given additional intravenous drip of levocarnitine on basis of the treatment of the control group.The white blood cells（WBC）counts,serum tumor necrosis factor（TNF-α）level and cardiac function indexes[left ventricular end systolic diameter（LVESD）,left ventricular end-diastolic volume（LVEDV）,left heart ejection fraction（LVEF）and heart rate（HR）]were compared between the two groups of patients before and after the treatment,and the curative effect and incidence of complications were observed and compared between the two groups of patients.RESULTS There were no significant differences in the levels of serum inflammatory factors such as WBC counts and TNF-αbetween the two groups of patients before the treatment.The levels of WBC counts and TNF-αof the two groups of patients were improved after the treatment,which were improved more significantly in the experimental group than in the control group（P〈0.05）.There were no significant differences in the cardiac function indexes such as LVESD,LVEDV,LVEF and HR between the two groups of patients before the treatment;the LVESD,LVEDV,LVEF and HR of the two groups of patients were improved after the treatment,which were improved more significantly in the experimental group than in the control group（P〈0.05）.The total effective rate of treatment of the experimental group was 95.56%,significantly higher than the control group（P〈0.05）.The incidence of complications of the experimental group was significantly lower than that of the control group after the treatment（P〈0.05）.CONCLUSION Xuebijing injection combined with levocarnitine may effectively improve the cardiac function indexes of the middle aged patients with infectious endocarditis,prevent the inflammatory reactions and reduce the incidence of complications such as heart failure and myocardial infarction,with the therapeutic value significant,it is worthy to be promoted.