高通量血液透析联合左卡尼汀治疗尿毒症心肌病的临床研究

Clinical Curative Effect of High Flux Hemodialysis Combined with Levocarnitine on Uremic Cardiomyopathy

目的:综合分析高通量血液透析联合左卡尼汀治疗尿毒症心肌病的临床治疗效果。方法:选取本院2014年3月-2016年10月收治的尿毒症心肌病患者78例,按照不同的治疗方法随机分为试验组(高通量血液透析联合左卡尼汀治疗)与对照组(普通血液透析治疗),各39例。两组均连续治疗7个月。观察分析两组治疗前后的血常规指标(血细胞比容、血红蛋白)和心脏彩超结构变化(左心室舒张期末内径、左心室收缩末期内径、射血分数)以及生化指标(尿素氮、血清肌酐和白蛋白)。结果:(1)治疗前两组血常规指标比较差异均无统计学意义(P>0.05),治疗后试验组血常规指标均显著高于对照组(P<0.05);(2)治疗前两组心脏彩超结构变化比较差异均无统计学意义(P>0.05),治疗后试验组患者射血分数增高,左心室舒张期末内径、左心室收缩末期内径均显著低于对照组(P<0.05);(3)治疗前两组生化指标比较差异均无统计学意义(P>0.05),治疗后试验组尿素氮、血清肌酐水平均显著低于对照组(P<0.05),试验组白蛋白水平显著高于对照组(P<0.05)。结论:高通量血液透析联合左卡尼汀治疗尿毒症心肌病的临床效果显著。

Objective： To analyze the clinical curative effect of high flux hemodialysis combined with Levoearnitine on uremic cardiomyopathy.Method： 78 patients with uremic cardiomyopathy treated in our hospital from March 2014 to October 2016 according to the different treatment methods were randomly divided into the experimental group （ high flux hemodialysis combined with Levocarnitine therapy ） and the control group （ hemodialysis therapy ）, 39 cases in each group.Two groups were treated continuously for 7 months. Blood routine indexes （ hematoerit, hemoglobin ）, echocardiography （ structural changes of left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular diastolic function, ejection fraction ） and biochemical indicators （ blood urea nitrogen, serum creatinine and albumin ） of two groups before and after treatment were compared.Result： （ 1 ） Before treatment, the blood routine indexes of two groups were compared, the differences were not statistically significant （ P〉0.05 ） ; after treatment, the blood routine indexes of the experimental group were significantly higher than those of the control group （ P〈0.05 ） . （ 2 ） Before treatment, echocardiography of two groups was compared, the difference was not statistically significant （P〉0.05） .Aftertreatment, the left ventricular end diastolic diameter, left ventricular end systolic diameter of the experimental group were lower than those of the control group, ejection fraction was higher than that of the control group （ P〈O.05 ） . （ 3 ） Before treatment, biochemical indicators of two groups were compared, the differences were not statistically significant （ P〉O.05 ） .After treatment, urea nitrogen and the serum creatinine level of the experimental group were significantly lower than those of the control group, and the albumin level of the experimental group was significantly higher than that of the control group （ P〈0.05 ） .Conclusion： The clinical curative effect of high flux hemodialysis combined with Levocarnitine on uremic cardiomyopathy is significant.