左卡尼汀联合曲美他嗪治疗缺血性心肌病心力衰竭患者的临床疗效

摘要

目的 观察左卡尼汀联合曲美他嗪治疗缺血性心肌病心力衰竭患者的临床疗效.方法 选取湖北省宜城市人民医院心内科2013年4月-2016年4月收治的缺血性心肌病心力衰竭患者240例,采用随机数字表法分为A、B、C 3组,每组80例.在常规治疗基础上,A组患者采用左卡尼汀治疗,B组患者采用曲美他嗪治疗,C组患者采用左卡尼汀联合曲美他嗪治疗;3组患者均连续治疗3个月.比较3组患者临床疗效、治疗前后心功能指标及心肌细胞功能指标,并观察两组患者治疗期间不良反应发生情况.结果 C组患者临床疗效优于A组和B组(P<0.05);但A组和B组患者临床疗效比较,差异无统计学意义(P>0.05).治疗前3组患者左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05);治疗后C组患者LAD和LVEDD小于A组和B组,LVESD小于A组,LVEF高于A组和B组(P<0.05).治疗前3组患者血清氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)水平比较,差异无统计学意义(P>0.05);治疗后C组患者血清NT-proBNP、cTnI水平低于A组和B组(P<0.05).治疗期间3组患者均未出现严重不良反应.结论 左卡尼汀联合曲美他嗪治疗缺血性心肌病心力衰竭患者的临床疗效确切,能有效改善患者心功能和心肌细胞功能,且安全性较高.%Objective To observe the clinical effect of levocarnitine combined with trimetazidine in treating ischemic cardiomyopathy patients complicated with heart failure.Methods From April 2013 to April 2016,a total of 240 ischemic cardiomyopathy patients complicated with heart failure were selected in the Department of Cardiology,the People′s Hospital of Yicheng,and they were divided into A group,B group and C group,each of 80 cases.Based on conventional treatment,patients of A group received levocarnitine,patients of B group received trimetazidine,while patients of C group received levocarnitine combined with trimetazidine;all of the three groups continuously treated for 3 months.Clinical effect,index of cardiac function and myocardial cell function before and after treatment were compared among the three groups,and incidence of adverse reactions was observed during the treatment.Results Clinical effect of C group was statistically significantly better than that of A group and B group,respectively(P<0.05),while no statistically significant differences of clinical effect was found between A group and B group(P>0.05).No statistically significant differences of LAD,LVEDD,LVESD or LVEF was found among the three groups before treatment(P>0.05);after treatment,LAD and LVEDD of C group were statistically significantly shorter than those of A group and B group,LVESD of C group was statistically statistically significantly shorter than that of A group,while LVEF of C group was statistically significantly higher than that of A group and B group,respectively(P<0.05).No statistically significant differences of serum level of NT-proBNP or cTnI was found among the three groups before treatment(P>0.05),while serum levels of NT-proBNP and cTnI of C group were statistically significantly lower than those of A group and B group after treatment(P<0.05).No one of the three group occurred any serious adverse reactions during the treatment.Conclusion Levocarnitine combined with trimetazidine has certain clinical effect in treating ischemic cardiomyopathy patients complicated with heart failure,can effectively improve the cardiac function and myocardial cell function,and is relatively safe.