摘要
目的：探讨左卡尼汀对老年慢性充血性心力衰竭（CHF）患者血清B型脑钠肽和β-内啡肽水平影响及疗效。方法采用随机数字表法将86例CHF患者分为观察组与对照组各43例。两组患者予以卧床休息、吸氧、低钠饮食、强心利尿和扩张血管等常规治疗。观察组加用左卡尼汀2．0 g静脉滴注，1次／d，连用14 d。观察两组治疗前和治疗14 d后血清 BNP和β-内啡肽水平变化，并比较其临床疗效及不良反应。结果治疗14 d后，两组血清BNP和β-内啡肽[（345．85±58．25）pg／mL、（120．84±25．13）pg／mL、（237．04±60．54） pg／mL、（92．08±26．17） pg／mL]均较治疗前[（405．28±83．07） pg／mL、（146．42±30．72） pg／mL、（410.23±75．12）pg／mL、（150．56±32．51）pg／mL]明显下降（t ＝2．24、2．31、3．18、2．96，P＜0．05或P＜0.01），且观察组较对照组下降更明显（t＝2．41、2．28，均P＜0．05）；观察组总有效率（95．35％）明显高于对照组（81．40％）（χ^2＝4．07，P＜0．05）；两组治疗中共发生不良反应6例，其中观察组4例，对照组2例，症状较轻，两组不良反应发生率差异无统计学意义（χ^2＝0．18，P＞0．05）。结论左卡尼汀是一种辅助治疗老年人CHF安全有效的药物，作用机制与降低血清BNP和β-内啡肽水平、调节神经内分泌激素水平密切有关。
Objective To discuss influence and curative effects of Levocarnitine on serum B-type natriuretic peptide （BNP） and β-endorphin levels of old patients with chronic congestive heart failure （CHF）.Methods 86 patients with CHF were divided into the observation group and control group by random number table.The patients in the two groups were given routine anti-heart failure treatment,such as bed rest,oxygen uptake,low sodium diet,strong heart diuresis,dilation of blood vessels and etc.The patients in the observation group were additionally given 2.0g Levocarnitine by intravenous infusion once a day for 14 days.The changes of serum BNP and β-endorphin levels of patients in the two groups before and 14 days after medical treatment were observed,and clinical curative effect and untoward effect were compared as well.Results After 14 days medical treatment,the serum BNP and β-endorphin levels of patients in the two groups[（345.85 ±58.25）pg/mL,（120.84 ±25.13）pg/mL,（237.04 ±60.54）pg/mL, （92.08 ±26.17） pg/mL] obviously declined than before （405.28 ±83.07） pg/mL,（146.42 ±30.72） pg/mL, （410.23 ±75.12）pg/mL,（150.56 ±32.51）pg/mL]（t=2.24,2.31,3.18,2.96,P〈0.05 or P〈0.01）,and the declining rate in the observation group was much higher than that in the control group （t=2.41,2.28,all P〈0.05）. Meanwhile,total efficiency in the observation group （95.35%） was much higher than that in the control group （81.40%）（χ^2 =4.07,P〈0.05）.6 cases of untoward effect appeared on patients in the two groups during the medi-cal treatment,including 4 cases in the observation group and 2 cases in the control group with light symptom.After comparing the occurrence rates of untoward effect,no obvious statistical difference appeared （χ^2 =0.18,P〉0.05）. Conclusion Levocarnitine is a kind of adjunctive therapy （AT） drug to treat CHF,whose mechanism of action has close effect on reducing serum BNP andβ-endorphin levels and adjusting neuroendocrine hormone levels.
出处
《中国基层医药》
CAS
2014年第23期3550-3552,共3页
Chinese Journal of Primary Medicine and Pharmacy
