左卡尼汀治疗慢性肾衰竭合并冠心病心律失常的效果观察

Effect of levocarnitine in treatment of chronic renal failure combining with arrhythmia of coronary heart disease

目的探讨左卡尼汀治疗慢性肾衰竭合并冠心病心律失常的临床效果。方法选取2011年4月~2012年6月入住本院进行治疗的48例慢性肾衰竭合并冠心病心律失常患者作为研究对象,将其随机分为对照组和观察组,每组24例,对照组进行常规治疗,如血液透析治疗、降压药物治疗、贫血纠正治疗、扩张血管药物治疗以及强心利尿药物治疗,观察组在常规治疗的基础上采用左卡尼汀进行治疗,患者进行透析后,静脉注射左卡尼汀1 g。两组患者均治疗3个月,治疗结束后,比较两组的临床疗效。结果观察组治疗总有效率为87.50%,明显高于对照组的66.67%,差异有统计学意义（P〈0.05）。治疗后,两组患者的左心室射血分数均明显提高,左心室收缩末期内径和左心室舒张末期内径均明显降低,差异有统计学意义（P〈0.05）;观察组治疗后的各项指标改善程度均明显高于对照组,差异有统计学意义（P〈0.05）。结论左卡尼汀能够有效治疗慢性肾衰竭合并冠心病心律失常,有效改善患者的肾功能和心功能,使患者的生活质量得到提升,值得临床推广应用。

Objective To observe the clinical effect of levocarnitine in the treatment of chronic renal failure combining with arrhythmia of coronary heart disease. Methods 48 patients with chronic renal failure and arrhythmia of coronary heart disease admitted into our hospital from April 2011 to June 2012 were selected as research objects.They were randomly divided into control group and observation group,24 cases in each group.Conventional treatments like hemodialysis,antihypertension,anemia correction,drugs on dilating blood vessel,strengthening heart and promoting urination were applied to control group.Levocarnitine was added to observation group on the basis of conventional treatment,after hemodialysis,1 g levocarnitine was intravenously injected.Patients in both groups were treated for 3 months.After therapy,the curative effect was compared between the two groups. Results The total effective rate of observation group was87.50%,higher than 66.67% of control group,the difference was significant（P〈0.05）.After treatment,left ventricular ejection fraction of two groups was increased,left ventricular systolic diameter and left ventricular end-diastolic diameter was decreased compared with before treatment,the difference was significant（P〈0.05）;the improvement of observation group was better than that of control group,the difference was significant（P〈0.05）. Conclusion Levocarnitine can effectively treat chronic renal failure combining with arrhythmia of coronary heart disease,improve patients′ renal and cardiac functions as well as their quality of lives,which is worthy of expanded application in clinic.