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目的观察左卡尼汀注射液联合阿托伐他汀钙片治疗慢性心力衰竭的临床疗效及安全性。方法将72例慢性心力衰竭患者随机分为对照组36例与试验组36例。对照组予以阿托伐他汀钙10 mg,qd,口服;试验组在对照组治疗的基础上,予以20 mg·kg~(-1)左卡尼汀注射液,qd,静脉推注。2组患者一个周期均为21 d,共治疗2个周期。比较2组患者的临床疗效、核转录因子-κB、白细胞介素~(-1)β、C反应蛋白、血浆脑利钠肽、左心室内径、左心室射血分数、6 min步行试验最大距离,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为83.33%(30/36例)和61.11%(22/36例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的核转录因子-κB分别为(34.44±3.50),(49.57±5.17)pg·L~(-1);白细胞介素~(-1)β分别为(0.42±0.05),(0.59±0.07)μg·L~(-1);C反应蛋白分别为(10.04±1.11),(13.29±1.44)ng·L~(-1);血浆脑利钠肽分别为(241.63±25.77),(340.92±35.16)pg·L~(-1);左心室内径分别为(49.19±5.12),(52.11±5.44)mm;左心室射血分数分别为(49.39±5.12)%,(41.02±4.15)%;6 min步行试验最大距离分别为(376.09±40.15),(262.98±28.71)m,差异均有统计学意义(P<0.05)。试验组的药物不良反应主要有胃肠道不适和口干,对照组的药物不良反应主要有胃肠道不适、视觉模糊和皮疹。试验组和对照组的药物不良反应发生率分别为5.56%和11.11%,差异无统计学意义(P>0.05)。结论左卡尼汀注射液联合阿托伐他汀钙片治疗慢性心力衰竭的临床疗效显著,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of levocarnitine injection combined with atorvastatin calcium in the treatment of chronic heart failure. Methods Seventy-two patients with chronic heart failure were randomly divided into control group (36 cases) and experimental group (36 cases). The control group was given atorvastatin calcium 10 mg qd orally; the experimental group was given 20 mg · kg -1 levocarnitine injection, qd and intravenous injection on the basis of the control group. The two groups of patients with a cycle of 21 d, a total of 2 cycles. The clinical efficacy, nuclear factor-κB, interleukin-1β, C-reactive protein, plasma brain natriuretic peptide, left ventricular diameter, left ventricular ejection fraction, maximum distance of 6 min walk test , And the occurrence of adverse drug reactions. Results After treatment, the total effective rates of the experimental group and the control group were 83.33% (30/36 cases) and 61.11% (22/36 cases), respectively, with statistical significance (P <0.05). After treatment, the levels of NF-κB in the test group and control group were (34.44 ± 3.50) and (49.57 ± 5.17) pg · L -1, respectively. The levels of interleukin- 0.05) and (0.59 ± 0.07) μg · L -1, respectively. The levels of C-reactive protein were (10.04 ± 1.11) and (13.29 ± 1.44) ng · L -1, 241.63 ± 25.77 and 340.92 ± 35.16 pg · L -1, respectively. The left ventricular diameters were (49.19 ± 5.12) and (52.11 ± 5.44) mm respectively. The left ventricular ejection fraction were (49.39 ± 5.12)% , (41.02 ± 4.15)%, respectively. The maximum distance of walking test at 6 min was (376.09 ± 40.15) and (262.98 ± 28.71) m, respectively, with statistical significance (P <0.05). Adverse drug reactions in the experimental group mainly gastrointestinal discomfort and dry mouth, the adverse drug reactions in the control group mainly gastrointestinal discomfort, blurred vision and rash. The incidence of adverse drug reactions in the experimental and control groups were 5.56% and 11.11%, respectively, with no significant difference (P> 0.05). Conclusion Lcacitrin injection combined with atorvastatin calcium in the treatment of chronic heart failure has a significant clinical effect, and does not increase the incidence of adverse drug reactions.