替米沙坦联合左卡尼汀治疗腹膜透析患者疗效分析

Clinical therapeutic effect of telmisartan in combined with L-carnitine on the peritoneal dialysis patients

目的：观察替米沙坦联合左卡尼汀对腹膜透析（PD）患者的临床疗效,以指导临床用药。方法：选择我科2011年11月~2014年1月随访的80例慢性肾功能衰竭（CRF）接受PD的患者为研究对象,随机分为治疗组和对照组;两组均常规进行PD,治疗组给予左卡尼汀口服液10mL/次、3次/d,替米沙坦80mg/次、1次/d,对照组给予左卡尼汀口服液10mL/次、3次/d,两组均连续服用24周;观察两组治疗前后血清肌酐（SCr）、尿毒氮（BUN）水平,并计算残余肾功能（RRF）,观察治疗前后日均尿量及血压变化。结果：治疗后,治疗组SCr、BUN降低大于对照组,RRF降低小于对照组（P〈0.05）;治疗后日尿量均减少,治疗组减少低于对照组（P〈0.05）;治疗后收缩压和舒张压均降低,治疗组降低优于对照组（P〈0.05）。结论：替米沙坦联合左卡尼汀用于尿毒症PD患者,能够有效延缓RRF的丧失,延缓尿量减少,调节血压水平,进而缓解临床症状,提高患者生存质量。

Objective：To observe the therapeutic effect of telmisartan in combined with L-carnitine on the peritoneal dialysis（PD）patients in order to guide the clinical medication.Methods：A total of 80 patients with chronic renal failure（CRF）who were admitted in our hospital from November,2011 to January,2014 for PD were included in the study and randomized into the treatment group and the control group.The patients in the two groups were routinely performed with PD.The patients in the treatment group were given L-carnitine oral liquid,10 mL/time,3times/d,and telmisartan,80 mg/time,1time/d.The patients in the control group were given L-carnitine oral liquid,10mL/time,3times a day.The patients in the two groups were treated for 24 weeks continuously.The serum SCr and BUN levels before and after treatment in the two groups were observed.Residual renal function（RRF）was calculated.The changes of daily average urine volume and blood pressure before and after treatment in the two groups were observed.Results：After treatment,the reduced degree of SCr and BUN in the treatment group was significantly greater than that in the control group,while the reduced degree of RRF was significantly less than that in the control group（P〈0.05）.After treatment,the daily urine volume was reduced,but the reduced degree in the treatment group was significantly less than that in the control group（P〈0.05）.After treatment,SBP and DBP were reduced,but the reduced degree in the treatment group was significantly superior to that in the control group（P〈0.05）.Conclusions：Telmisartan in combined with L-carnitine applied in PD patients can effectively delay the loss of RRF and the reduction of urine volume,and regulate the blood pressure in order to alleviate the clinical symptoms and improve the patients’ living qualities.