左卡尼汀改善老年心力衰竭病人心肌缺血及心功能  

Role of L-carnitine in improving cardiac function and relieving myocardial ischemia in elderly patients with congestive heart failure

作　　者：胡珺[1] 朱福[1] 谢骏[1] 汪思阳[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,上海200031

出　　处：《药学服务与研究》2008年第3期181-183,共3页Pharmaceutical Care and Research

摘　　要：目的:观察老年心力衰竭病人应用左卡尼汀治疗后,心肌缺血及心功能改善情况。方法:67例临床诊断为心力衰竭的病人随机分为2组,对照组32例常规抗心力衰竭治疗,常规治疗药物包括洋地黄、袢利尿剂、扩血管药物硝酸盐制剂、血管紧张素转换酶抑制剂。左卡尼汀组35例除常规治疗外,加用左卡尼汀2 g/次,1次/d,静脉滴注,共两周;为加强疗效,3个月后重复予左卡尼汀治疗两周,比较两组治疗前后及组间左心室射血分数(LVEF)、心电图及胸闷症状缓解情况。结果:左卡尼汀组治疗后常规12导联中ST段压低总和及ST段压低>0.5 mm的导联数均明显降低(P<0.01或P<0.05),LVEF值显著升高(P<0.01),与对照组比较具有统计学非常显著性差异(P<0.01)。左卡尼汀组胸闷缓解率亦明显高于对照组(P<0.01)。结论:老年心力衰竭病人联合应用左卡尼汀可改善心肌缺血及心功能。Objective：To observe the changes of cardiac function and myocardial ischemia of the elderly patients with congestive heart failure （CHF） after treated with L-carnitine. Methods： Sixty-seven elderly patients with CHF were randomized into control group（ 32 cases） and L-carnitine group （35 cases）. All of the patients received basic treatment with digitalis, loop diuretic,nitrates for dilating blood vessels and angiotensin converting enzyme inhibitor according to heart failure treatment guideline. The patients in L-carnitine group additionally received L-carnitine 2 g/dose intravenous drip qd for two weeks and the therapy was repeated 3 months later. Left ventricular ejection fraction（LVEF）,electrocardiogram（ECG） and remission of chest distress were recorded and compared before and after the treatment in two groups. Results：After the treatment, lead number of depressed ST segment （NST） and ∑depressed ST segment （∑ST） of the patients in L-carnitine group were significantly decreased （P〈0.01 or P〈0.05） and the LVEF was increased significantly（P〈0.01） compared with those in control group. The differences of remission of chest distress were significant between the two groups（P〈0.01）. Conclusion： The combination treatment with L-carnitine is effective in improvement of cardiac function and relief of myocardial ischcmia in elderly patients with CHF.

关 键 词：左卡尼汀 心力哀竭 充血性 心肌缺血 老年人 

分 类 号：R969.4[医药卫生—药理学] R541.61[医药卫生—药学]