左卡尼汀联合抗菌药物治疗自体瓣膜心内膜炎的临床观察  

Clinical Observation of L-carnitin Combined with Antibiotics in the Treatment of Native Valve Endocarditis

作　　者：刘玉峰[1] 刘晓刚[1] 顾晔[1] 胡立群[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院心内科,武汉430000

出　　处：《中国药房》2016年第14期1972-1974,共3页China Pharmacy

摘　　要：目的:观察左卡尼汀联合抗菌药物治疗自体瓣膜心内膜炎的临床疗效及安全性。方法:采用回顾性研究方法,将100例自体瓣膜心内膜炎患者根据用药方案不同分为对照组与观察组,各50例。对照组患者给予抗菌药物及补液、降温等相关对症支持治疗;观察组患者在对照组治疗基础上加用左卡尼汀注射液静脉滴注,每次1 g,qd,两组疗程均为4周。观察两组患者的临床疗效、治疗前后的心功能指标[左室射血分数(LVEF)、每搏输出量(SV)、心排出量(CO)、心脏指数(CI)]与血清炎性介质[C反应蛋白(CRP)、白细胞介素(IL)6、IL-8、肿瘤坏死因子(TNF)α]水平,以及并发症发生情况。结果:观察组患者的总有效率为90.0%,显著高于对照组(78.0%),差异有统计学意义(P<0.05)。治疗后两组患者的LVEF、SV、CO、CI水平均显著高于治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05);治疗后两组患者的CRP、IL-6、IL-8、TNF-α水平均显著低于治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。治疗期间观察组患者的并发症发生率(8.0%)显著低于对照组(20.0%),差异有统计学意义(P<0.05)。结论:左卡尼汀联合抗菌药物治疗自体瓣膜心内膜炎较单纯抗菌药物治疗可获得更好的疗效,能有效控制感染、改善心脏功能,且能明显降低血清炎性介质水平和相关并发症的发生率。OBJECTIVE：To observe the effects and safety of L-carnitine combined with antibiotics in the treatment of native valve endocarditis. METHODS：In retrospective study,a total of 100 patients with native valve infective endocarditis were randomly divided into control group and observation group with 50 cases in each group. Control group received corresponding symptomatic and supportive treatment,such as antibiotics,fluid infusion,lowering temperature;observation group was additionally given L-carnitine injection intravenously,1 g each time,qd,on the basis of control group. The treatment course of 2 groups lasted for 4weeks. Clinical efficacy,heart function index（LVEF,SV,CO,CI）and serum inflammatory medium（CRP,IL-6,IL-8,TNF-α）were observed in 2 groups,and the occurrence of complications was also observed. RESULTS：The total effective rate of observation group was 90.0%,which was significantly higher than control group（78.0%）,with statistical significance（P〈0.05）. The levels of LVEF,SV,CO and CI in 2 groups after treatment were significantly higher than before treatment,the observation group was significantly higher than the control group,with statistical significance（P〈0.05）;the levels of CRP,IL-6,IL-8 and TNF-αin 2 groups after treatment was significantly lower than before treatment,the observation group was significantly lower than the control group,with statistical significance（P〈0.05）. The incidence of complications in observation group（8.0%）was significantly lower than in control group（20.0%）during treatment,with statistical significance（P〈0.05）. CONCLUSIONS：L-carnitine combined antibiotics is better than antibiotics alone in the treatment of native valve endocarditis,can effectively control infection improve cardiac function,and significantly reduce the serum levels of inflammatory mediators and the incidence of complications.

关 键 词：自体瓣膜心内膜炎 抗菌药物 左卡尼汀 血清炎性介质 

分 类 号：R542.41[医药卫生—心血管疾病]