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目的对比观察环磷腺苷葡胺注射液(MCA)与左卡尼汀注射液治疗老年心力衰竭患者的临床疗效。方法将42例老年心力衰竭患者随机分为MCA组和左卡尼汀组各21例。2组均在常规治疗的基础上分别加用MCA和左卡尼汀,治疗1个疗程(10d)后分别测定2组患者的左室射血分数(LVEF值)和血浆脑钠肽(BNP)水平。结果治疗前,2组同一心功能分级间LVEF及血浆BNP比较差异均无统计学意义(P>0.05)。治疗后,MCA组Ⅱ、Ⅲ、Ⅳ级患者BNP水平均低于治疗前,左卡尼汀组Ⅲ级患者BNP水平低于治疗前,差异均有统计学意义(P<0.05)。MCA组BNP升高幅度大于左卡尼汀组,差异有统计学意义(P<0.05)。结论老年心力衰竭患者BNP水平明显增高,在常规治疗基础上加用MCA和左卡尼汀均可进一步降低血浆BNP水平,而MCA比左卡尼汀疗效更佳。
Objective To compare the clinical efficacy of cyclic adenosine monophosphate (MCA) and levocarnitine in the treatment of elderly patients with heart failure. Methods Forty-two elderly patients with heart failure were randomly divided into MCA group and L-carnitine group, 21 cases each. The two groups were treated with MCA and L-carnitine on the basis of routine treatment. After one course of treatment (10 days), the left ventricular ejection fraction (LVEF) and plasma brain natriuretic peptide (BNP) Level. Results Before treatment, there was no significant difference in LVEF and plasma BNP between the two groups in the same cardiac function classification (P> 0.05). After treatment, BNP levels in patients with stage II, III and IV MCA were lower than before treatment, BNP levels in patients with levocarnitine Ⅲ were lower than before treatment (P <0.05). The increase of BNP in MCA group was greater than that in L-carnitine group, the difference was statistically significant (P <0.05). Conclusions BNP levels in elderly patients with heart failure are significantly higher. Adding MCA and L-carnitine can further decrease plasma BNP levels in patients with heart failure, while MCA is more effective than L-carnitine.