左卡尼汀对慢性充血性心衰患者心功能、心室重构和生活质量的影响

Influence of levocarnitine on heart function, ventricular remodeling and quality of life in patients with chronic congestive heart failure

目的观察左卡尼汀对慢性充血性心力衰竭(CCHF)患者心功能、心室重构和生活质量的影响。方法 120例CCHF患者随机分为对照组和观察组各60例,对照组予常规治疗,观察组在此基础上加用左卡尼汀,8周为一疗程。比较两组临床疗效、心功能、6 min步行距离(6MWD),血清N末端脑钠肽前体(NT-proBNP)、超敏肌钙蛋白T(hs-cTnT)和基质金属蛋白酶(MMP),明尼苏达心力衰竭生活质量量表(MLHFQ)评价生活质量,记录不良反应。结果观察组临床总有效率为91.7%,明显高于对照组的71.7%(P<0.05)。治疗后,观察组左室射血分数(LVEF)、NT-proBNP、hs-cTnT、6MWD、MMP-2、MMP-9,及MLHFQ量表中身体领域及总分均明显优于对照组(均P<0.05)。两组均无明显不良反应出现。结论左卡尼汀治疗CCHF安全有效,值得临床推广。

Objective To observe the influence of levocarnitine on heart function,ventricular remodeling and quality of life(QOL)in patients with chronic congestive heart failure(CCHF).Methods CCHF patients(n=120)were randomly divided into control group and observation group(each n=60),and control group was given routine therapy and observation group was additionally given levocarnitine for 8 weeks as one therapeutic course.The clinical efficacy,heart function,6-minute walk distance(6MWD),and serum NT-proBNP,hs-cTnT and matrix metalloproteinase(MMP)were compared between 2 groups.QOL was reviewed by using Minnesota Living with Heart Failure Questionnaire(MLHFQ),and adverse reactions were recorded.Results The total clinical efficacy was 91.7%in observation group,which was significantly higher than that in control group(71.7%,P<0.05).After treatment,LVEF,NT-proBNP,hs-cTnT,6MWD,MMP-2,MMP-9 and scores of physical dimensions and the total score of MLHFQ were all significantly superior in observation group to those in control group(all P<0.05).There were no evident adverse reactions observed in 2 groups.Conclusion Levocarnitine is safe and effective in treatment of CCHF,which is worth clinical promoting.