左卡尼汀联合前列地尔对慢性肾功能衰竭患者合并心功能衰竭的临床疗效

Clinical efficacy of alprostadil combined with levocarnitine in treatment of chronic renal failure combined with heart failure

目的探讨左卡尼汀联合前列地尔对慢性肾功能衰竭患者合并心功能衰竭的临床疗效。方法选取80例慢性肾功能衰竭合并心功能衰竭患者,随机分为两组,对照组(39例)给予前列地尔治疗,观察组(41例)给予左卡尼汀联合前列地尔治疗,观察并记录两组治疗前后心功能系数、肾功能指标、SF-36量表评分及治疗期间不良反应情况,评价左卡尼汀联合前列地尔对慢性肾功能衰竭合并心功能衰竭患者的临床疗效。结果治疗前,两组心输出量(CO)、心脏指数(CI)、心肌耗氧量(MVO)、射血分数(EF)水平相比,差异无统计学意义;治疗后,两组CO、CI、MVO水平均降低且观察组上述指标值更低(P<0.05);治疗后观察组EF值明显增加且高于对照组(P<0.05),对照组EF值与治疗前相比无明显改变。治疗前两组胱抑素C(CysC)、血尿素氮(BUN)、血肌酐(SCr)水平相比,差异无统计学意义;治疗后,两组CysC、BUN、SCr水平均降低且观察组上述指标值更低(P<0.05)。治疗前,两组SF-36量表各项评分相比,差异无统计学意义;治疗后观察组在生理功能、生理职能、总体健康上的评分均明显高于对照组(P<0.05),其余各项评分相比差异无统计学意义。治疗期间,两组不良反应率差异无统计学意义。结论左卡尼汀联合前列地尔对慢性肾功能衰竭合并心功能衰竭具有较好的疗效,能明显改善患者心功能,降低心脏负荷;改善肾功能,增加肾小球滤过率;进而改善患者生活质量,联合用药具有安全性,值得临床推广使用。

Objective To discuss the efficacy of alprostadil and levocarnitine in treatment of chronic renal failure combined with heart failure.Methods Totally 80 patients with chronic renal failure complicated with heart failure were selected,and randomly divided into two groups.The control group （39 cases） was given alprostadil.The observation group （41 cases） was given alprostadil and levocarnitine.The efficacy of alprostadil and levocamitine in treatment of chronic renal failure combined with heart failure was evaluated by cardiac fimction indexes,renal function indexes,SF-36 scale score,and adverse reaction during the treatment.Results Before treatment,there was no statistical significance on CO,CI,MVO,and EF between two groups.After treatment,the CO,CI,and MVO were decreased and lower in the observation group （P 〈 0.05）.The EF was increased in the observation group and higher than that of the control group （P 〈 0.05）.The EF had no changes in the control group.Before treatment,there was no statistical significance on CysC,BUN,and SCr between two groups before treatment,without statistical significance.After treatment,CysC,BUN,and SCr were decreased in two groups and lower in the observation group （P 〈 0.05）.Before treatment,there was no statistical significance on SF-36 scores between two groups.After treatment,the physiological function,physical function,and general health were higher than those of the control group （P 〈 0.05）.There was no statistical significance on the rest of the scores.During treatment,there was no statistical significance on adverse reaction between two groups.Conclusion Alprostadil and levocarnitine had a good curative effect on chronic renal failure combined with heart failure.It could improve the heart function by reducing cardiac load,improve the renal function by increasing glomerular filtration rate and improve the quality of life with good safety.It is worthy of clinical application.