左卡尼汀治疗冠心病心肌缺血的临床效果

Clinical effect of levocarnitine in the treatment of coronary heart disease with myocardial ischemia

目的探讨左卡尼汀治疗冠心病心肌缺血的临床效果。方法选择2016年7月至2018年12月榆林市子洲县人民医院内科收治的100例冠心病心肌缺血患者,根据随机数字表法将其分为对照组与观察组,各50例。对照组给予常规治疗方案,观察组在常规治疗基础上加用左卡尼汀进行治疗。比较两组的临床疗效、心肌缺血总负荷、血流动力学指标、心功能指标、血清炎性因子水平及不良反应发生情况。结果观察组的临床治疗总有效率为96.00%,显著高于对照组的82.00%,差异具有统计学意义(P<0.05)。治疗后,两组的心肌缺血总负荷均降低,且观察组低于对照组(P<0.05)。治疗后,两组的收缩期时间、收缩期峰值速度、收缩期速度时间积分均改善,且观察组优于对照组(P<0.05)。治疗后,两组患者的左心射血分数均升高,NT-proBNP水平均降低,6 min步行距离均增大,且观察组均优于对照组(P<0.05)。治疗后,两组的CRP、IL-6水平均降低,且观察组均低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论左卡尼汀可有效改善冠心病心肌缺血患者的血流动力学指标,减轻其心肌缺血状况,有利于改善其心功能,减轻炎症反应,具有良好的临床疗效,且不良反应少,安全性高。

Objective To explore the clinical effect of levocarnitine in the treatment of coronary heart disease with myocardial ischemia. Methods From July 2016 to December 2018, 100 cases coronary heart disease patients with myocardial ischemia admitted in the internal medicine department of the People’s hospital of Zizhou county of Yulin city were divided into control group and observation group according to the random number table method, with 50 cases in each group. The control group was given conventional treatment scheme, while the observation group was treated with levorcarnitine on the basis of conventional treatment. The clinical efficacy, total load of myocardial ischemic, hemodynamic indexes, cardiac function indexes, serum inflammatory factor leves and adverse reactions of the two groups were compared.Results The total effective rate of clinical treatment in the observation group was 96.00%, which was significantly higher than 82.00% in the control group, and the difference was statistically significant(P<0.05). After treatment, the total load of myocardial ischemia in both groups decreased, and that in the observation group was lower than the control group( P<0.05).After treatment, the time systolic, systolic velocity and systolic velocity-time integral of the two groups improved, and those in the observation group were better than the control group(P<0.05). After treatment, the left ventricular ejection fraction of the two groups increased, the level of NT-proBNP decreased, and the 6-min walking distance increased, and those in the observation group were better than the control group(P<0.05). After treatment, the levels of CRP and IL-6 in both groups decreased, and those in the observation group were lower than the control group(P <0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P >0.05). Conclusion Levocarnitine can effectively improve the hemodynamic indexes of coronary heart disease patients with myocardial ischemia, reduce the myocardial ischemia state, ameliorate the cardiac function, and reduce the inflammatory response. It has a good clinical effect, less adverse reactions and high safety.