左旋卡尼汀治疗维持性血液透析患者心功能不全的疗效观察

Effect of L-carnitine on Cardiac Insufficiency in Patients on Maintenance Hemodialysis

目的:探讨左旋卡尼汀治疗维持性血液透析(maintenance hemodialysis,MHD)患者心功能不全的临床疗效。方法:选择规律血液透析病情稳定达到3个月以上的患者40例,每周血液透析2~3次,随机分为对照组20例和治疗组20例,对照组给予常规血液透析治疗,辅以应用促红细胞生成素、纠正贫血、降压药、洋地黄制剂、利尿剂、扩血管剂等常规治疗。治疗组除给予与对照组相同治疗外,每次血液透析治疗后静脉注射左旋卡尼汀1.0g,疗程2个月,观察治疗前和治疗2月后观察患者的心率、血压、心电图、左心室收缩末内径(LVESD)、左心室收缩末容量(LVESV)、左心室射血分数(LVEF),心脏指数(CO)及对透析耐受性和血浆肉毒碱浓度变化。结果:应用左旋卡尼汀2个月后血浆肉毒碱浓度从(30.4±8.0)μmol/L提高至(123.50±22.15)μmol/L;与治疗前比较患者心率(HR),收缩压(SBP),舒张压(DBP),LVESD、LVESV、LVEF、CO分别有改善,均有统计学差异(P【0.05)。结论:左旋卡尼汀可作为MHD患者改善心功能不全的有效辅助治疗之一。

Objective:To explore the therapeutic effects of L-carnitine 12on cardiac insufficiency in patients on maintenance hemodialysis 3.Methods:To choose the law to achieve stability in hemodialysis patients for more than 3 months in patients with 40 cases,2-3 times a week hemodialysis,were randomly divided into control group,20 cases and 20 cases of treatment group,control group given conventional hemodialysis treatment,supplemented by the application of erythropoietin to correct anemia,antihypertensive drugs,digitalis preparations,diuretics,vasodilative agents conventional therapy.In addition to the treatment group with the control group the same treatment,after each hemodialysis intravenous L-carnitine 1g,course of 2 months to observe the pre-treatment and treatment in February after the observation of patients with heart rate,blood pressure,electrocardiogram,left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),cardiac index(CO) and on dialysis tolerance and changes in plasma carnitine concentration.Results:The application of L-carnitine after 2 months from the plasma carnitine concentration(30.4 ± 8.0) μmol / L to(123.50 ± 22.15) μmol / L;and heart rate in patients before treatment(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),LVESD,LVESV,LVEF,CO,respectively,to improve,there is significant difference(P <0.05).Conclusion:L-carnitine can be used as maintenance hemodialysis patients to improve heart failure,one of the effective adjuvant therapy.