左卡尼汀治疗老年急性冠脉综合征前后血清心衰 标志物的水平变化分析

Analysis of changes of serum heart failure markersbefore and after levocarnitine treatment for elderlypatients with acute coronary syndrome

目的探讨左卡尼汀治疗老年急性冠脉综合征(ACS)前后血清心衰标志物的水平变化。方法选取2018年10月至2019年10月本院收治的188例ACS老年患者,根据治疗方法的不同分为对照组和观察组,每组94例。对照组采用常规治疗,观察组在常规治疗基础上加用左卡尼汀治疗。比较两组患者血清心衰标志物水平、心功能参数、不良反应发生情况。结果治疗后,观察组患者胱抑素C(CysC)、脑钠尿肽(BNP)、N末端脑钠尿肽前体(NT-proBNP)、左室收缩末期容积(LVESD)、左室舒张末期容积(LVEDD)水平均低于对照组,左室射血分数(LVEF)、心排血量(CO)水平和二尖瓣舒张早期与晚期血流峰值比值(E/A)均高于对照组,差异均有统计学意义(P<0.05);两组患者不良反应发生率比较差异无统计学意义。结论左卡尼汀治疗ACS老年患者可有效改善血清心衰标志物水平与心功能,且不增加不良反应,值得临床推广应用。

Objective To investigate the changes of serum heart failure markers before and after levocarnitine treatment for elderly patients with-acute coronary syndrome(ACS).Methods 188 elderly patients with ACS admitted to our hospital from October 2018 to October 2019 were selected and divided into control group and observation group according to different treatment methods,with 94 cases in each group.The control group was treated with routine treatment,and the observation group was treated with levocarnitine on the basis of routine treatment.The serum levels of heart failure markers,cardiac function parameters and the incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of cystatin C(CysC),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide precursor(NT-proBNP),left ventricular end systolic volume(LVESD)and left ventricular end-diastolic volume(LVEDD)in the observation group were all lower than those in the control group,left ventricular ejection fraction(LVEF),cardiac output(CO)and the ratio between early and late diastolic peak flow velocity across the mitral valve(E/A)in the observation group were all higher than those in the control group,the difference was statistically significant(P<0.05).There was no sta-tistically significant difference in the incidence of adverse reactions between the two groups.Conclusion The application of levocarnitine in the treatment of elderly ACS patients can effectively improve the level of serum heart failure markers and cardiac function,and do not increase adverse reactions,which is worthy of clinical promotion and application.