论文部分内容阅读
目的评价左卡尼汀联合辅酶Q10治疗慢性重症心力衰竭的临床疗效及安全性。方法将196名慢性心力衰竭心功能Ⅲ~Ⅳ级患者按性别年龄配对后,将每个对子随机分为试验组和对照组,每组各98例。对照组予以酒石酸美托洛尔,每次100 mg,bid+氯沙坦50 mg,qd+螺内酯40 mg,bid等常规抗心力衰竭治疗;试验组在对照组的基础上,加用左卡尼汀20 mg·kg-1,bid+辅酶Q10,每次10 mg,tid。2组患者疗程均为7 d。比较2组患者治疗后心功能改善情况以及不良反应发生率。结果试验组的总有效率达89.80%显著高于对照组63.27%(P<0.05)。治疗后,试验组的C反应蛋白含量和B型尿钠肽检测水平显著低于对照组(P<0.05),试验组的6 min步行距离明显远于对照组(P<0.05),试验组的左心室射血分数显著高于对照组(P<0.05),左心室舒张期末径和左心室收缩末期内径明显低于对照组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论左卡尼汀联合辅酶Q10能显著提高重症慢性心力衰竭治疗的临床疗效,且不增加不良反应的发生率。
Objective To evaluate the clinical efficacy and safety of levocarnitine combined with coenzyme Q10 in the treatment of chronic severe heart failure. Methods 196 pairs of patients with chronic heart failure heart function grade Ⅲ ~ Ⅳ were paired by sex age, each pair was randomly divided into experimental group and control group, 98 cases in each group. The patients in the control group were treated with metoprolol tartrate, 100 mg bid, bid + losartan 50 mg, qd + spironolactone 40 mg, bid and other conventional anti-heart failure treatment. On the basis of the control group, mg · kg-1, bid + coenzyme Q10, each 10 mg, tid. Two groups of patients were treated for 7 days. The improvement of cardiac function and the incidence of adverse reactions in two groups were compared. Results The total effective rate of the experimental group was 89.80%, significantly higher than that of the control group (63.27%, P <0.05). After treatment, the levels of C-reactive protein and B-type natriuretic peptide in the test group were significantly lower than those in the control group (P <0.05), and the walking distance in the test group was significantly longer than that in the control group (P <0.05) The left ventricular ejection fraction was significantly higher than that of the control group (P <0.05). The diameter of the left ventricular end diastolic dimension and the diameter of the left ventricular end-systolic dimension were significantly lower than those of the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion L-carnitine combined with coenzyme Q10 can significantly improve the clinical efficacy of treatment of severe chronic heart failure, and does not increase the incidence of adverse reactions.