摘要
目的研究左卡尼汀对扩张型心肌病(DCM)的治疗效果。方法将46例DCM患者随机分为左卡尼汀组和对照组各23例,对照组给予常规治疗,左卡尼汀组在此基础上加用左卡尼汀注射液3.0 g/d,持续14 d,此为治疗第1阶段;之后改为左卡尼汀口服液1.0 g/d,持续2个月,此为治疗第2阶段。所有患者于治疗前和治疗第1阶段结束时行彩色多普勒超声心动图和血清中脑钠肽(BNP)检查,比较两组患者治疗前后心功能改善情况及BNP下降程度。对所有患者随访2个月,随访结束时复查超声心动图,并根据明尼苏达心衰生活质量评分表(MLWHF)评分,对比两组患者心室结构及生活质量改善情况。结果①第1阶段治疗后,左卡尼汀组和对照组心功能改善总有效率之间差异无统计学意义(P>0.05),但显效率分别为56.5%和26.1%,差异有统计学意义(P<0.05);②两组心功能指标左室射血分数(LVEF)、每搏输出量(SV)、每分心输出量(CO)、心脏指数(CI)及血清中BNP水平较治疗前均有所改善,但左卡尼汀组效果更明显(P<0.05);③治疗2个月后,超声心动图显示,两组治疗后左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)较治疗前均有缩小趋势,但差异无统计学意义(P>0.05);④左卡尼汀组患者MLWHF评分优于对照组(P<0.05)。结论左卡尼汀可较快缓解DCM患者心衰症状、改善心功能,长期服用有利于改善心室代谢重构和患者生活质量。
[Objective] To evaluate the curative effect of L-carnitine （L-CN） on patients with dilated cardiomyopathy （DCM）. [ Methods ] 46 DCM patients were randomly divided into L-CN group and the control group, 23 cases in each group. Patients in the control group received the routine treatment. On the basis of routine treatment, L-CN group was given L-CN intravenous injection, 3.0 g/d for 14 days （ the first stage I, afterwards patients were treated with L-CN oral liquid, 1.0 g/d for 2 months （ the second stage）. All patients received the color Doppler echocardiography and serum BNP detection before treatment and after the first stage of treatment. The improvement of heart function and decrease of BNP level before and after treatment were compared between two groups. The patients were followed for 2 months. At the end of follow-up, all patients were tested by color Doppler echocardio- graphy and Minnesota Living with Heart Failure Questionnaire （ MLWHF}, to compare the ventricular structure and quality of life between two groups. [ Results ] ①0After the first stage of treatment, there was no significant difference in total effective rate of heart function improvement between the L-CN group and the control group （P 〉0. 05 ）. However, the total obvious effective rate of two groups was 56.5% and 26.1% respectively, and the difference was significant （ P 〈 0. 05 ）. ② After treatment, LVEF SV, CO, CI and serum BNP level have improved in both groups, and the effect in L-CN group was more obvious （P 〈 0. 05）. ③ LVEDD and LVESD decreased after 2 months of treatment in both groups, but there was no significant difference （ P 〉 0.05 ）. ④MLWHF score of L-CN group was better than that of the control group （ P 〈0.05 ）. [ Conclusion] L-CN can rapidly relieve the symptoms of heart failure and improve the cardiac function in DCM patients, and long-term administration may improve ventricular metabolic re- modeling and life quality of patients.
出处
《职业与健康》
CAS
2013年第15期1966-1968,共3页
Occupation and Health
关键词
心肌病
充血性
左卡尼汀
心室功能
代谢重构
Cardiomyopathy
Congestive
L-carnitine （ L-CN I
Cardiac function
Metabolic remodeling
