CAJ | 학술논문

目的：探讨用左卡尼汀（L-CN）治疗缺血性心肌病（ICM）合并慢性心力衰竭(CHF)的临床效果。对2012年1月～2014年1月期间我院收治的92例缺血性心肌病合并慢性心力衰竭患者的临床资料进行回顾性研究。我们将这92例患者随机分为观察组和对照组，每组各有46例患者。我院使用常规药物疗法对对照组患者进行治疗，对观察组患者在进行常规药物治疗（方法与对照组患者相同）的基础上，加用左卡尼汀进行治疗。治疗结束后，比较两组患者治疗的效果、治疗前后6MWT（6分钟步行试验）的距离、LVEF（左心射血分数）、LVFS（左室短轴缩短率）、LVEDD（左心室舒张末期内径）和E（E波，舒张早期充盈波）/A（A波，舒张晚期充盈波）值。结果：观察组患者治疗的总有效率明显高于对照组患者，二者相比差异具有显著性（P＜0.05）。在治疗前，两组患者6MWT的距离、LVEF、LVFS、LVEDD和E/A值相比无显著性差异（P＞0.05）。在治疗后，两组患者6MWT的距离、LVEF、LVFS、LVEDD和E/A值均较治疗前有明显的改善，其中，观察组患者治疗后6MWT的距离、LVEF、LVFS、LVEDD和E/A值均明显优于对照组患者，二者相比差异具有显著性（P＜0.05）。结论：用左卡尼汀治疗缺血性心肌病合并慢性心力衰竭效果确切，可有效地改善患者的心功能。此药可作为临床上治疗缺血性心肌病合并慢性心力衰竭的优选药物。
목적：탐토용좌잡니정（L-CN）치료결혈성심기병（ICM）합병만성심력쇠갈(CHF)적림상효과。대2012년1월～2014년1월기간아원수치적92례결혈성심기병합병만성심력쇠갈환자적림상자료진행회고성연구。아문장저92례환자수궤분위관찰조화대조조，매조각유46례환자。아원사용상규약물요법대대조조환자진행치료，대관찰조환자재진행상규약물치료（방법여대조조환자상동）적기출상，가용좌잡니정진행치료。치료결속후，비교량조환자치료적효과、치료전후6MWT（6분종보행시험）적거리、LVEF（좌심사혈분수）、LVFS（좌실단축축단솔）、LVEDD（좌심실서장말기내경）화E（E파，서장조기충영파）/A（A파，서장만기충영파）치。결과：관찰조환자치료적총유효솔명현고우대조조환자，이자상비차이구유현저성（P＜0.05）。재치료전，량조환자6MWT적거리、LVEF、LVFS、LVEDD화E/A치상비무현저성차이（P＞0.05）。재치료후，량조환자6MWT적거리、LVEF、LVFS、LVEDD화E/A치균교치료전유명현적개선，기중，관찰조환자치료후6MWT적거리、LVEF、LVFS、LVEDD화E/A치균명현우우대조조환자，이자상비차이구유현저성（P＜0.05）。결론：용좌잡니정치료결혈성심기병합병만성심력쇠갈효과학절，가유효지개선환자적심공능。차약가작위림상상치료결혈성심기병합병만성심력쇠갈적우선약물。
Objective:To observe the clinical efficacy of the treatment of combing with L-carnitine (L-CN) on the basis of conventional anti-heart failure drug in patients with ischemic cardiomyopathy with chronic heart failure (CHF). Methods:92 cases of ischemic heart disease in patients with chronic heart failure were randomly divided into two groups, each group of 46 patients in the control group was treated with diuretics, ACEI, aldosterone antagonists, B-blockers, digitalis and other conventional drugs, the treatment group on the basis of conventional drug treatment 10 to 14 days after the addition of L-carnitine 3 g/d treatment observed in patients with improvement of cardiac function,6-minute walk test(6MWT) and echocardiographic parameters change. Results: (1) After treatment, the treatment group total effective rate was 91.3%, 73.9% in the control group. The difference of the total efficiency was statistically significant in the both groups.(P<0.05). (2) compare the two sets of the same group after treatment than treatment before NYHA functional classification, 6MWT,LVEDD, LVEF, LVFS and E / A ratio improved (P<0.05), but after treatment between the two groups, the treatment group than The control group improved more significantly (P<0.05). The Conclusion: Combined with Levocarnitine in conventional drug treatment of ischemic cardiomyopathy chronic heart failure can significantly improve cardiac function.