摘要
目的观察左卡尼汀联合曲美他嗪治疗老年扩张型心肌病(DCM)患者的效果。方法选取195例老年DCM患者,随机分为观察组、对照A组和对照B组,各65例。对照A组予以左卡尼汀治疗,对照B组予以曲美他嗪治疗,观察组予以左卡尼汀联合曲美他嗪治疗。比较3组临床疗效,以及治疗前后血清透明质酸、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)、心肌肌钙蛋白(cTnT)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白水平及左心室心肌T1值、左室舒张期内径(LVEDD)、左室射血分数(LVEF),并比较3组治疗过程中不良反应发生率。结果治疗后,观察组治疗总有效率优于对照A、B组(P<0.05)。对照A组、对照B组、观察组血清透明质酸、PCⅢ、LN、cTnT、cTnI、CK-MB、肌红蛋白水平、增强前左心室心肌T1值、LVEDD依次降低,增强后左心室心肌T1值、LVEF依次升高(P<0.05);3组不良反应发生率差异无统计学意义(P>0.05)。结论与单独用药相比,曲美他嗪联合左卡尼汀治疗老年DCM患者,可更有效地改善心肌纤维化,促进心功能恢复。
Objective To observe the efficacy of levocarnitine combined with trimetazidine for the treatment of elderly patients with dilated cardiomyopathy(DCM).Methods A total of 195 elderly patients with DCM enrolled were randomly divided into observation group,control group A and control group B,with 65 cases in each group.The control group A was treated with levocarnitine,the control group B was treated with trimetazidine,and the observation group was treated with levocarnitine combined with trimetazidine.Clinical efficacy,as well as serum levels of hyaluronic acid,procollagen typeⅢ(PCⅢ),laminin(LN),cardiac troponin T(cTnT),cardiac troponin I(cTnI),creatine kinase-MB isoenzyme(CK-MB),and myoglobin,left ventricular myocardial T1 value,left ventricular end-diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)before and after the treatment,was compared among the three groups,and the incidence rate of adverse reactions during the treatment was compared among the three groups.Results After the treatment,the observation group was superior to the control groups A and B in the total effective rate for treatment(P<0.05).Serum levels of hyaluronic acid,PCⅢ,LN,cTnT,cTnI,CK-MB,and myoglobin,left ventricular myocardial T1 value before enhancement,and LVEDD decreased,while left ventricular myocardial T1 value after enhancement and LVEF increased in the control group A,control group B and observation group successively(P<0.05);there was no statistically significant difference in the incidence rate of adverse reactions among the three groups(P>0.05).Conclusion Compared with monotherapy,trimetazidine combined with levocarnitine can improve myocardial fibrosis more effectively and promote the recovery of cardiac function in the treatment of elderly DCM patients.
作者
徐伟丽
刘勇先
朱华强
XU Wei-li;LIU Yong-xian;ZHU Hua-qiang(Department of Cardiovascular Medicine,Weihai Municipal Third Hospital,Weihai 264200,China)
出处
《广西医学》
CAS
2021年第21期2544-2548,共5页
Guangxi Medical Journal
关键词
扩张型心肌病
曲美他嗪
左卡尼汀
心肌纤维化
心功能
老年人
Dilated cardiomyopathy
Trimetazidine
Levocarnitine
Myocardial fibrosis
Cardiac function
Elderly person
