左卡尼汀和低温透析预防透析相关性低血压的疗效

Efficacy of L-carnitine and Cryogenic Dialysis in the Prevention of Dialysis-related Hypotension

目的 探讨左卡尼汀和低温透析预防透析相关性低血压的疗效。方法 选择2019年1月至2020年1月在本院行维持性血液透析(规律透析)且反复发生透析相关性低血压的80例患者作为研究对象,根据干预方式分为常规组、低温组、左卡尼汀组和联合组,各20例。常规组采用37℃透析液常规透析,低温组采用35.5℃透析液完成透析,左卡尼汀组采用透析液温度为37℃+左卡尼汀治疗,联合组采用35.5℃透析液+左卡尼汀1 g治疗,对比4组患者透析期间血压水平差异,并监测预防透析相关性低血压发生情况及干预次数。结果 联合组透析开始前、透析中最低和透析后1 h SBP、DBP均显著高于常规组、低温组、左卡尼汀组,差异有统计学意义(P <0.05)。4组患者20次透析中,联合组每次透析低血压平均发生例次(2.18±0.68)次和平均干预例次(1.11±0.42)次,均显著低于低温组、左卡尼汀组和常规组,差异有统计学意义(P <0.05)。结论 反复透析相关性低血压患者采用低温透析联合左卡尼汀治疗,可有效减少透析中和透析后血压降低幅度,有效防范低血压情况的发生,疗效可靠。

Objective To investigate the efficacy of L-carnitine and hypothermic dialysis in the prevention of dialysis-related hypotension. Methods A total of 80 patients who underwent maintenance hemodialysis(regular dialysis) in our hospital from January 2019 to January 2020 and had recurrent dialysis-related hypotension were selected as the research subjects. According to the intervention method, it was divided into the routine group,hypothermia group, L-carnitine group and combined group, 20 cases each. The routine group was treated with 37 ℃ dialysate routine dialysis, the hypotermia group was treated with 35.5 ℃ dialysate, the L-carnitine group was treated with dialysate temperature of 37 ℃ + levocarnitine, and the combination group was treated with 35.5 ℃ dialysate + levocarnitine nitin 1 g treatment, compared the blood pressure levels during dialysis in the four groups, and monitored the occurrence of dialysis-related hypotension and the number of interventions. Results The SBP and DBP in the combined group before the start of dialysis, the lowest in dialysis, and one hour after dialysis were significantly higher than those in the conventional group,cryogenic group and levocaniptine group, and the difference was statistically significant(P<0.05). In the 20 dialysis sessions of patients in the 4 groups,the average number of hypotension occurrences(2.18±0.68) and the average number of interventions(1.11±0.42) times per dialysis in the combined group were significantly lower than those in the hypothermia group, the L-carnitine group, and the routine group, the difference was statistically significant(P<0.05). Conclusion In patients with repeated dialysis-related hypotension, hypothermic dialysis combined with L-carnitine treatment can effectively reduce the blood pressure drop during and after dialysis, and effectively prevent the occurrence of hypotension, with reliable curative effect.