左卡尼汀联合替米沙坦对充血性心衰患者心功能、炎症因子及D-二聚体水平的影响  

Influence of levocarnitine combined telmisartan on cardiac function, levels of inflammatory factors and D-dimer in patients with congetive heart failure

作　　者：张科成 吴滨 ZHANG Ke-cheng;WU Bin(Department of Cardiology,Traditional Chinese Hospital of Yingkou City,Yingkou,Liaoning,115000,China)

机构地区：[1]营口市中医院心内科,辽宁营口115000

出　　处：《心血管康复医学杂志》2021年第5期578-582,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨左卡尼汀联合替米沙坦对充血性心力衰竭(CHF)患者心功能、炎症因子及D-二聚体(D-D)水平的影响。方法:选择2018年4月~2019年4月我院收治的CHF患者140例,患者被随机均分为左卡尼汀组(常规治疗基础上使用左卡尼汀治疗)和联合治疗组(在左卡尼汀组基础上联合替米沙坦治疗),两组均连续治疗8周。观察比较两组治疗前后心输出量(CO)、LVEF、左室舒张末容积(LVEDV)、血清基质金属蛋白酶(MMP)-9、白介素(IL)-6、肿瘤坏死因子(TNF)-α、N末端脑钠肽原(NT-proBNP)、心肌肌钙蛋白I(cTnI)、D-D水平及疗效。结果:与左卡尼汀组比较,治疗8周后联合治疗组CO[(4.6±1.0)L/min比(5.3±1.1)L/min]、LVEF[(42.2±3.2)%比(54.9±3.4)%]、总有效率(85.7%比95.7%)显著升高,LVEDV[(49.3±4.1)ml比(35.7±4.8)ml]、血清MMP-9[(153.4±22.0)pg/ml比(102.4±21.9)pg/ml]、IL-6[(193.5±16.3)pg/ml比(166.6±15.4)pg/ml]、TNF-α[(25.2±3.1)ng/ml比(21.1±2.4)ng/ml]、NT-proBNP[(226.8±123.3)pg/ml比(133.3±58.9)pg/ml]、cTnI[(0.40±0.17)μg/L比(0.30±0.09)μg/L]和D-D[(468.1±142.1)μg/ml比(337.2±104.8)μg/ml]水平显著降低,P<0.05或<0.01。结论:在充血性心力衰竭治疗中,左卡尼汀联合替米沙坦疗效显著,可显著改善心功能,降低炎症因子水平,值得推广。Objective:To explore influence of levocarnitine combined telmisartan on cardiac function,levels of inflammatory factors and D-dimer(D-D)in patients with congetive heart failure(CHF).Methods:A total of 140 CHF patients treated in our hospital from Apr 2018 to Apr 2019 were randomly and equally divided into levocarnitine group(received levocarnitine based on routine treatment)and combined treatment group(received telmisartan based on levocarnitine group),both groups were continuously treated for eight weeks.Cardiac output(CO),LVEF,left ventricular end-diastolic volume(LVEDV),serum levels of matrix metalloproteinase(MMP)-9,interleukin(IL)-6,tumor necrosis factor(TNF)-α,N terminal pro brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI)and D-D before and after treatment and therapeutic effect were observed and compared between two groups.Results:Compared with levocarnitine group after eight-week treatment,there were significant rise in CO[(4.6±1.0)L/min vs.(5.3±1.1)L/min],LVEF[(42.2±3.2)%vs.(54.9±3.4)%]and total effective rate(85.7%vs.95.7%),and significant reductions in LVEDV[(49.3±4.1)ml vs.(35.7±4.8)ml],serum levels of MMP-9[(153.4±22.0)pg/ml vs.(102.4±21.9)pg/ml],IL-6[(193.5±16.3)pg/ml vs.(166.6±15.4)pg/ml],TNF-α[(25.2±3.1)ng/ml vs.(21.1±2.4)ng/ml],NT-proBNP[(226.8±123.3)pg/ml vs.(133.3±58.9)pg/ml],cTnI[(0.40±0.17)μg/L vs.(0.30±0.09)μg/L]and D-D[(468.1±142.1)μg/ml vs.(337.2±104.8)μg/ml]in combined treatment group,P<0.05 or<0.01.Conclusion:Levocarnitine combined telmisartan possesses significant therapeutic effect on CHF.It can significantly improve cardiac function,reduce levels of inflammatory factors,which is worth extending.

关 键 词：心力衰竭 左卡尼汀 替米沙坦 

分 类 号：R541.61[医药卫生—心血管疾病]