左卡尼汀注射液联合福辛普利钠片用于维持性血液透析的临床研究

Clinical trial of levocarnitine injection combined with fosinopril sodium tablets in the treatment of maintenance hemodialysis

目的观察左卡尼汀注射液联合福辛普利钠片用于维持性血液透析的临床疗效及安全性。方法将97例维持性血液透析治疗患者随机分为对照组48例和试验组49例。对照组于每次透析结束前,予以左卡尼汀注射液1.0 g,静脉滴注;试验组在对照组治疗的基础上,予以福辛普利钠片每次10 mg,qd,口服。2组患者均治疗12周。比较2组患者的肾功能,炎症因子水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的血清肌酸酐分别为(874.86±73.69)和(906.50±75.59)μmol·L-1,血红蛋白分别为(119.37±6.83)和(109.37±6.80)g·L-1,血细胞比容分别为(37.89±1.80)%和(34.07±1.86)%,C反应蛋白分别为(5.40±0.97)和(6.58±1.25)mg·L-1,白细胞介素-6分别为(9.87±1.17)和(15.17±1.38)pg·m L-1,肿瘤坏死因子-α分别为(10.14±1.02)和(13.88±1.37)pg·m L-1,差异均有统计学意义(均P<0.05)。试验组出现的药物不良反应主要有头晕和胃肠道反应,对照组出现的药物不良反应主要有乏力和胃肠道反应。试验组和对照组的总药物不良反应发生率分别为8.16%和4.17%,差异无统计学意义(P>0.05)。结论左卡尼汀注射液联合福辛普利钠片用于维持性血液透析可有效地改善患者的肾功能和炎症状态,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of levocarnitine injection combined with fosinopril sodium tablets in the treatment of maintenance hemodialysis.Methods Ninety-seven patients with maintenance hemodialysis were randomly divided intocontrol group(n=48 cases)and treatment group(n=49 cases).Control group was given levocarnitine injection 1.0 g before the end of dialysis,intravenous drip.Treatment group received fosinopril sodium tablets 10 mg per time,qd,orally,on the basis ofcontrol group.Two groups were treated for 12weeks.The renal function,inflammatory factors and adverse drug reactions were compared between two groups.Results After treatment,the main indexes of treatment and control groups were compared:serum creatinine were(874.86±73.69)and(906.50±75.59)μmol·L-1,hemoglobin were(119.37±6.83)and(109.37±6.80)g·L-1,hematocrit were(37.89±1.80)%and(34.07±1.86)%,C reactive protein were(5.40±0.97)and(6.58±1.25)mg·L-1,interleukin-6were(9.87±1.17)and(15.17±1.38)pg·m L-1,tumor necrosis factor-αwere(10.14±1.02)and(13.88±1.37)pg·m L-1,the differences were statistically significant(all P<0.05).The adverse drug reactions of treatment group were dizziness and gastrointestinal reactions,which in control group were fatigue and gastrointestinal reactions.The total incidences of adverse drug reactions in the treatment and control groups were 8.16%and 4.17%without significant difference(P>0.05).Conclusion Levocarnitine injection combined with fosinopril sodium tablets for maintenance hemodialysis can effectively improve renal function and inflammatory state,without increasing the incidence of adverse drug reactions.