左旋卡尼汀、镁-极化液配伍治疗缺血性心脏病心力衰竭45例临床观察

Clinical observation of L-carnitine and Mg-GIK on 45 patients with ischemic heart disease and congestive heart failure

目的 :评估左旋卡尼汀 ( L- CN)与镁 -极化液 ( Mg- GIK)配伍治疗缺血性心脏病( IHD)心力衰竭疗效和安全性。方法 :选择 IHD心力衰竭患者 90例 ,心功能 ( NYHA分级 ) ～ 级 ,随机分成两组 ,对照组给予硝酸酯类、利尿剂、洋地黄、β-受体阻滞剂、血管紧张素转换酶抑制剂、Mg- GIK等常规治疗 ;治疗组在常规治疗的基础上 ,每次给予 L- CN2 .0 g加入 Mg- GIK液中静滴 ,2～ 3h滴入 ,每天 1次 ,1 0 d为 1个疗程。结果 :治疗后心功能改善总有效率 :对照组为 66.7% ,治疗组为 91 .1 % ,两组相比有显著性差异 ( P<0 .0 1 )。心电图心肌缺血 ST- T改善总有效率 :对照组为 5 3.3% ,治疗组为 77.8% ,两组相比有显著性差异 ( P<0 .0 5 )。随访观察 3个月 ,对照组再入院率为 31 .1 % ,而治疗组仅为 8.9% ,两组相比有显著性差异 ( P<0 .0 5 ) ,两组病死率无明显差异 ( P>0 .0 5 )。两组均无药物不良反应。结论 :L-CN与 Mg- GIK配伍能有效改善 IHD心力衰竭患者心功能和心肌缺血 ,减少再入院率 。

Objective: To evaluate clinical effect of L-carnitine (L-CN) and Mg-GIK on patients with ischemic heart disease (IHD) and congestive heart failure. Mothods: 90 cases of IHD and congestive heart failure were randomly divided into the control group of normal treatment (Nitrates, diuretics, digitalis, βblocker, ACEI, Mg-GIK) and treatment group (normal treatment combined with L-CN). The treatment course was ten days. Results: The effective rate in improving heart function was 91.1% in treatment group and 66.7% in the control group after ten days (P<0.01). No adverse reactions related to the drug were observed. Conclusion: L-CN and Mg-GIK combined with normal treatment can improve heart function effectively when used to treat IHD and congestive heart failure.