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左卡尼汀治疗慢性充血性心力衰竭的疗效观察
引用本文:黎琳.左卡尼汀治疗慢性充血性心力衰竭的疗效观察[J].中国航天工业医药,2011(7):56-58.
作者姓名:黎琳
作者单位:重庆市江津区第二人民医院心内科,402260
摘    要:目的观察左卡尼汀治疗慢性充血性心力衰竭的疗效。方法入选65例NYHA心功能分级Ⅲ~Ⅳ级的慢性充血性心力衰竭患者,随机分为左卡尼汀治疗组35例和对照组30例。左卡尼汀组在常规治疗基础上给予左卡尼汀3g/d口服,连用14d。对照组给予常规治疗。分别于治疗前及治疗14d后进行6min步行试验、NYHA心功能分级、LVEF及血清生化等指标的检查,评价两组的疗效,记录不良反应。结果治疗前后比较,两组6min步行距离、左室射血分数和NYHA心功能分级均较治疗前有明显改善(P=0.031,0.042,0.20)。两组血清BNP水平均有降低(P=0.026)。治疗后两组间比较,左卡尼汀组6min步行距离平均增加32m,对照组平均增加15m(P=0.036);LVEF平均增加12%,对照组平均增加7%(P=0.044);B型利钠肽水平下降61.22ng/L,而对照组下降46.18ng/L(P=0.038);左卡尼汀组心功能改善1级以上共32例,对照组共19例(P=0.019)。所有实验对象均无肝肾功能损害及严重不良反应。结论左卡尼汀可以改善慢性左心衰竭患者的6分钟步行距离、LVEF和心功能,降低B型利钠肽水平,提高运动耐量,是一种安全、有效的药物。

关 键 词:左卡尼汀  慢性充血性心力衰竭

Evaluation of the therapeutic effects of L-Carnitine on chronic congestive heart failure
Authors:Li Lin
Institution:Li Lin.The Second People's Hospital of Jiangjin District,Chongqing City,Chongqing 402260
Abstract:Objective To evaluate the therapeutic effects of L-Carnitine on chronic congestive heart failure.Methods A total of 65 patients with confirmed diagnosis of chronic congestive heart failure were included in this study,patients were divided into L-Carnitine group(n=35) and control group(n=30).All patients received conventional treatment according to guideline for chronic congestive heart failure.The patients in L-Carnitine group received 3g/d L-Carnitine po for 14 days.Six-minute walking distance,LVEF,serum BNP level and NYHA heart functional class were evaluated at baseline and 14 days after enrollment.Results Compared to the baseline,six-minute walking distance,LVEF,and NYHA heart functional class were significantly improved(P=0.031,0.042,0.020 respectively),serum BNP level was significantly decreased(P=0.026).But the increase of six-minute walking distance was greater in the L-Carnitine group than control group(32m in mean vs 15m,P=0.036),the increase of LVEF in the L-Carnitine group was also higher than control group(12% vs 7%,P=0.044),the decrease of serum level of BNP in L-Carnitine group was significant higher than control group(61.22ng/L vs 46.18ng/L,P0.038).The improvement of NYHA heart functional class was still different in 2 groups(32 cases in L-Carnitine group vs 19 cases in control group,P= 0.019).No subject quit the study for therapeutically induced severe dysfunction of liver and kidney.Conclusion L-Carnitine can improve short-term six-minute walking distance,LVEF and NYHA heart functional class in chronic congestive heart failure patients.
Keywords:L-Carnitine Chronic congestive heart failure
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