磷酸肌酸钠联合卡维地洛治疗扩张性心肌病心力衰竭临床研究

Clinical study of creatine phosphate sodium combined with carvedilol in the treatment of dilated cardiomyopathy heart failure

目的探讨磷酸肌酸钠与卡维地洛联合治疗扩张性心肌病心力衰竭的临床效果。方法选取2016年3月至2016年10月于我院收治的扩张性心肌病心力衰竭患者76例作为研究对象,采用随机数字表法分为观察组与对照组,每组38例。对照组患者采用卡维地洛治疗,观察组患者在对照组治疗的基础上联合使用磷酸肌酸钠治疗。比较两组患者的临床治疗效果,检测比较两组患者治疗前后的心功能指标、6 min步行步数变化情况以及不良反应发生情况。结果治疗2周后,观察组患者的治疗总有效率(94.74%)显著高于对照组,临床疗效优于对照组,差异均有统计学意义(P<0.05);观察组患者心率、左室舒张末期内径、左室收缩末期内径小于对照组,左室射血分数大于对照组,差异均有统计学意义(P<0.05);观察组患者6 min步行步数显著多于对照组,差异有统计学意义(P<0.01)。治疗期间观察组患者的不良反应发生率(2.63%)显著低于对照组(21.05%),差异有统计学意义(P<0.05)。结论磷酸肌酸钠联合卡维地洛治疗扩张性心肌病心力衰竭患者效果显著,可明显改善患者心率、左室收缩末期内径、左室舒张末期内径以及左室射血分数,提高运动耐受性,值得在临床推广应用。

Objective To investigate the clinical effect of creatine phosphate sodium combined with carvedilol in the treatment of dilated cardiomyopathy with heart failure. Methods 76 patients with dilated cardiomyopathy and heart failure admitted to our hospital from March 2016 to October 2016 were selected as the research subjects. They were randomly divided into observation group and control group,38 cases in each group. The control group was treated with carvedilol,and the observation group was treated with sodium phosphocreatine on the basis of the control group. The clinical therapeutic effects of the two groups were compared,and the indexes of cardiac function,the changes of 6 min walking steps and the occurrence of adverse reactions were compared between the two groups before and after treatment. Results After 2 weeks of treatment,the total effective rate of treatment（ 94. 74%） in the observation group was significantly higher than that of the control group. The clinical effect was better than that of the control group（ P〈0. 05）. The heart rate,left ventricular end diastolic diameter and left ventricular end systolic diameter of the observation group were less than the control group,and the left ventricular ejection fraction was larger than the control group,the difference was statistically significant（ P〈0. 05）. The walking time of 6 min in the observation group was significantly higher than that in the control group,and the difference was statistically significant（ P〈0. 01）. The incidence of adverse reactions in the observation group（ 2. 63%） was significantly lower than that in the control group（ 21. 05%） in the course of treatment,the difference was statistically significant（ P〈0. 05）. Conclusion Sodium phosphocreatine combined with carvedilol has significant effect on patients with dilated cardiomyopathy and heart failure. It can obviously improve heart rate,left ventricular end systolic diameter,left ventricular end diastolic diameter and left ventricular ejection fraction,and improve exercise tolerance. It is worthy of application in clinical practice.