CAJ | 학술논문

目的：探讨左卡尼汀治疗缺血性心肌病心力衰竭的临床价值。方法选取本院诊治的缺血性心肌病心力衰竭患者127例，随机被分为两组，常规治疗患者63例为对照组，常规治疗加用左卡尼汀患者64例为观察组，疗程3个月，比较两组临床病症改善情况、临床指标改变情况、临床疗效及不良反应。结果治疗后，两组左心室射血分数、左心室短轴缩短率、心输出量、每搏输出量、6分钟步行距离均明显增加，两组左心室舒张末期内径、左心室收缩末期内径、血浆 B 型钠尿肽均明显减小。观察组左心室射血分数、左心室短轴缩短率、心输出量、每搏输出量、6分钟步行距离均明显大于对照组，观察组左心室舒张末期内径、左心室收缩末期内径、血浆 B 型钠尿肽均明显小于对照组，观察组胸闷病症消失率、气短病症消失率、乏力病症消失率、水肿病症消失率、治疗总有效率均明显高于对照组(均 P<0.05)。结论左卡尼汀可明显改善缺血性心肌病心力衰竭患者的临床病症，显著改善患者的临床指标，临床疗效显著，引发的不良反应较少，具有较高的安全性。
목적：탐토좌잡니정치료결혈성심기병심력쇠갈적림상개치。방법선취본원진치적결혈성심기병심력쇠갈환자127례，수궤피분위량조，상규치료환자63례위대조조，상규치료가용좌잡니정환자64례위관찰조，료정3개월，비교량조림상병증개선정황、림상지표개변정황、림상료효급불량반응。결과치료후，량조좌심실사혈분수、좌심실단축축단솔、심수출량、매박수출량、6분종보행거리균명현증가，량조좌심실서장말기내경、좌심실수축말기내경、혈장 B 형납뇨태균명현감소。관찰조좌심실사혈분수、좌심실단축축단솔、심수출량、매박수출량、6분종보행거리균명현대우대조조，관찰조좌심실서장말기내경、좌심실수축말기내경、혈장 B 형납뇨태균명현소우대조조，관찰조흉민병증소실솔、기단병증소실솔、핍력병증소실솔、수종병증소실솔、치료총유효솔균명현고우대조조(균 P<0.05)。결론좌잡니정가명현개선결혈성심기병심력쇠갈환자적림상병증，현저개선환자적림상지표，림상료효현저，인발적불량반응교소，구유교고적안전성。
Objective To investigate the clinical value of levocarnitine in the treatment of heart failure in ischemic cardiomyopathy.Methods The study selected 127 patients with heart failure in ischemic cardiomyopathy from the hospital,who were randomly divided into two groups:control group and observation group.The control group included 63 patients who received routine treatment,while the observation group included 64 patients who received routine treatment and levocarnitine treatment.Course of treatment was 3 months.Improvement situation of clinical symptoms,changes of clinical indicators,clinical efficacy and adverse reactions were compared between two groups.Results After treatment,left ventricular ejection fraction,left ventricular shortening fraction,cardiac output, stroke volume and 6 min walking distance increased significantly in two groups.Left ventricular end diastolic diameter, left ventricular end systolic diameter and plasma B type natriuretic peptide decreased significantly in two groups.Left ventricular ejection fraction,left ventricular shortening fraction,cardiac output,stroke volume and 6 min walking distance in observation group were significantly larger than those of control group.Left ventricular end diastolic diameter,left ventricular end systolic diameter and plasma B type natriuretic peptide in observation group were significantly less than those of control group.The disappearance rate of chest diseases symptom,shortness of breath symptom,fatigue symptom and swelling symptom,and total effective rate of therapy in observation group were significantly higher than those of control group (all P < 0.05 ).Conclusion Levocarnitine could obviously improve clinical symptoms of patients with heart failure in ischemic cardiomyopathy,which could also significantly improve clinical indexes.Clinical efficacy of levocarnitine on ischemic cardiomyopathy is significant.It has less adverse reaction and more safety.