左卡尼汀序贯治疗老年人充血性心力衰竭

目的观察左卡尼汀(LC)序贯治疗老年人充血性心力衰竭(CHF)的近期疗效。方法对照组35例,常规按心衰治疗;LC组37例,在对照组基础上加用静滴LC 3 g/d×2周,后改服LC 2 g/d×2周。4周后比较两组患者治疗前后及组间NYHA心功能分级、明尼苏达心衰生活质量评分、ECG及UCG改善程度。结果(1)治疗后两组NYHA分级总有效率无显著差异,但LC组显效率高于对照组。(2)治疗后LC组CO、SV、EF、FS、VE/VA较治疗前明显升高。(3)治疗后LC组常规12导联中ST段压低>0.25 mm的导联数、常规12导联中ST段压低的总和较治疗前及对照组明显改善。(4)治疗后LC组明尼苏达心衰生活质量评分(MLWHF)高于对照组,血浆白蛋白、前白蛋白水平均较治疗前及对照组高。结论常规疗法联合应用LC序贯疗法治疗老年人CHF近期疗效显著、安全。

Effect of L-carnitine for treating congestive heart failure in the elderly

Objective To observe the shortterm clinic effects of L-carnitine(LC) of treating congestive heart failure(CHF) in the elderly.Methods There were 37 elderly cases with CHF in LC group and 35 cases in control group.They all received basic treatment according to heart failure guideline.The patients in LC group additionly received LC injection 3g/d intravenous for 2wk.After 2wk,they consequently received oral LC 1g Bid for another 2wk.After 4wk,the patients' indexes including NYHA、EKG、UCG、MLWHF、Alb and PAlb before and after treatment in two groups were compared.Results ①After treatment,the patients' improvement of totle NYHA efficacy rates were no significant in two groups,but prominent efficacy rate in LC group was higher than that in control group.②After treatment,the indexes including SV、CO、EF、FS、VE/VA in LC group were significantly higher than those before treatment.③After treatment,the indexes including NST、ΣST were significantly higher than those before treatment and control group.④After treatment,the evaluation indexes of MLWHF in LC group was higher than that in before treatment,the indexes as Alb、PAlb in LC group were higher than those before treatment and in control group.Conclusion The combination treatment by LC is effective and safe for treating CHF in the elderly.