左卡尼汀治疗老年慢性心力衰竭的临床疗效及其对心功能与血管活性分子的影响

目的:探讨左卡尼汀治疗老年慢性心力衰竭的临床疗效及对血管活性分子与心功能的影响。方法:选取2017年6月至2018年6月我院收治的120例老年慢性心力衰竭患者作为研究对象,随机分为观察组及对照组,对照组患者接受常规治疗,观察组在常规治疗的基础上给予左卡尼汀,比较两组患者的临床疗效、血管紧张素II(Ang II)、醛固酮(ALD)、一氧化氮(NO)、内皮素-1(ET-1)、左室射血分数(LVEF)、左室收缩末期内径(LVESD)及左室舒张末期内径(LVEDD)水平。结果:治疗前,两组患者的SV、CO、CI、VE、VA、VE/VA水平相当,差异无统计学意义(P0.05)。观察组的总有效率为91.67%,显著高于对照组65.00%的总有效率(P0.05)。治疗前,两组患者的LVEF、LVESD、LVEDD均无统计学差异(P0.05);治疗后,两组患者的LVEF均比治疗前升高,且观察组的LVEF较对照组更高,差异有统计学意义(P0.05);治疗后,两组患者的LVESD、LVEDD均比治疗前降低,且观察组的LVESD、LVEDD较对照组更低,差异均有统计学意义(P0.05)。治疗前,两组患者的Ang II、ALD、NO、ET-1水平均无统计学差异(P0.05);治疗后,两组患者的Ang II、ALD、ET-1均比治疗前降低,且观察组的Ang II、ALD、ET-1较对照组更低,差异均有统计学意义(P0.05);治疗后,两组患者的NO均比治疗前升高,且观察组的NO较对照组更高,差异有统计学意义(P0.05)。两组治疗期间均未出现明显不良反应。结论:左卡尼汀治疗老年慢性心力衰竭的临床疗效显著,能够有效改善血管活性分子水平及心功能,安全可靠。

Effect of L-carnitine on Chronic Heart Failure in Elderly Patients and Its Effects on Vasoactive Molecules and Cardiac Function

ABSTRACT Objective: To investigate the clinical efficacy of L-carnitine in the treatment of elderly patients with chronic heart failure and its effects on vasoactive molecules and cardiac function. Methods: 120 elderly patients with chronic heart failure admitted in our hospital from June 2017 to June 2018 were randomly divided into the observation group and the control group. The control group received routine treatment, while the observation group was given L-carnitine on the basis of routine treatment. The clinical efficacy, angiotensin II (Ang II), aldosterone (ALD), nitric oxide (NO), endothelin-1 (ET-1), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) of the two groups were compared. Results: Before treatment, the levels of SV, CO, CI, VE, VA and VE / VA in the two groups were similar, with no significant difference (P>0.05). The total effective rate of the observation group was 91.67%, which was significantly higher than that of the control group (65%) (P<0.05). Before treatment, there was no significant difference in LVEF, LVESD and LVEDD between the two groups (P>0.05). After treatment, the LVEF of the two groups was higher than before treatment, and the LVEF of the observation group was higher than that of the control group (P<0.05). After treatment, the LVESD and LVEDD of the two groups were lower than those before the treatment, and the LVESD and LVEDD in the observation group were lower than those of the control group, and the difference was statistically significant (P<0.05). Before treatment, there was no significant difference in the levels of Ang II, ALD, NO and ET-1 between the two groups (P>0.05). After treatment, the Ang II, ALD and ET-1 of the two groups were lower than those before the treatment, and the Ang II, ALD and ET-1 in the observation group were lower than those of the control group, and the difference was statistically significant (P<0.05). After treatment, the NO of the two groups was higher than before treatment, and the NO of the observation group was higher than that of the control group, with a statistically significant difference (P<0.05). No obvious adverse reactions were observed in the two groups during treatment. Conclusion: L-carnitine is effective in the treatment of elderly patients with chronic heart failure, and can effectively improve the level of vasoactive molecules and cardiac function, safe and reliable.