摘要
目的探讨尼可地尔联合左卡尼汀对心肌梗死后心力衰竭的疗效。方法回顾性分析浙江省金华市人民医院2019年12月-2020年7月收治的91例心肌梗死后心力衰竭患者的临床资料,按照治疗方法的不同分为对照组44例和研究组47例。其中对照组采用左卡尼汀3mg溶于0.9%氯化钠100mL混合后静脉滴注,1次/d。研究组在对照组基础上采用尼可地尔口服,5mg/次,3次/d。两组均连续治疗3个月。比较两组临床疗效、血清因子(NT-proBNP、TNF-α、IL-6、MMP-9)、心功能(LVEF、LVESD和LVEDD)以及不良反应发生情况。结果治疗后,研究组治疗总有效率高于对照组,差异具有统计学意义(χ^(2)=6.773,P<0.01);两组血清NT-proBNP、TNF-α、IL-6、MMP-9均下降(P<0.05),且研究组较对照组更低(P<0.01);两组LVEF较治疗前上升,而LVESD、LVEDD均较治疗后下降(P<0.05),且研究组改善程度均优于对照组(P<0.01);两组头晕、恶心呕吐等不良反应发生率比较差异均无统计学意义(P>0.05)。结论尼可地尔联合左卡尼汀治疗心肌梗死后心力衰竭疗效确切,可明显改善患者心功能,安全性好,具有临床推广意义。
Objective To investigate the effect of nicorandil combined with Levocarnitine on heart failure and cardiac function after myocardial infarction.Methods The clinical data of 91 patients with heart failure after myocardial infarction treated in Jinhua people's Hospital from December 2019 to July 2020 were retrospectively analyzed.According to different treatment methods,they were divided into control group(44 cases)and study group(47 cases).The control group was treated with Levocarnitine,and the study group was treated with nicorandil combined with Levocarnitine.The clinical efficacy and serum factors(NT-proBNP、TNF-α、IL-6、MMP-9),cardiac function(LVEF、LVESD and LVEDD)and adverse reactions.Results After treatment,the total effective rate of the study group was higher than that of the control group,the difference was statistically significant(χ^(2)=6.773,P<0.01);Serum NT proBNP and TNF in two groups TNF-α、IL-6 and MMP-9 decreased(P<0.05),and the level of IL-6 and MMP-9 in the study group was lower than that in the control group(P<0.01);LVEF of the two groups increased compared with that before treatment,while LVESD and LVEDD decreased compared with that after treatment(P<0.05),and the improvement degree of the study group was better than that of the control group(P<0.01);There was no significant difference in the incidence of dizziness,nausea and vomiting between the two groups(P>0.05).Conclusion Nicorandil combined with Levocarnitine is effective in the treatment of heart failure after myocardial infarction.It can significantly improve the cardiac function of patients with good safety and has clinical significance.
作者
张燕霞
徐俊艳
叶媛
郑佳琪
ZHANG Yanxia;XU Junyan;YE Yuan;ZHENG Jiaqi(Jinhua people’s Hospital,Jinhua 321000,China)
出处
《浙江实用医学》
2021年第6期458-460,479,共4页
Zhejiang Practical Medicine
关键词
心肌梗死
心力衰竭
尼可地尔
左卡尼汀
心功能
myocardial infarction
heart failure
Nicorandil
Levocarnitine
cardiac function
