左卡尼汀联合厄贝沙坦治疗终末期肾病维持性血液透析患者合并心功能不全的疗效研究  

Efficacy of L-carnitine combined with irbesartan on cardiac dysfunction in patients with end-stage renal disease undergoing maintenance hemodialysis

作　　者：陈铱特 杨伟鹏[1] 陈璇[1] 蔡洁华 Chen Yite;Yang Weipeng;Chen Xuan;Cai Jiehua(Department of Nephrology,Chaozhou Central Hospital,Chaozhou 521000,China)

机构地区：[1]广东省潮州市中心医院肾内科,521000

出　　处：《临床医学》2020年第2期85-87,共3页Clinical Medicine

摘　　要：目的探讨左卡尼汀联合厄贝沙坦治疗终末期肾病维持性血液透析患者合并心功能不全的疗效。方法选取2019年1月至2019年7月潮州市中心医院收治的终末期肾病维持性血液透析合并心功能不全的80例患者,随机分为对照组与观察组,每组40例。对照组患者口服150 mg厄贝沙坦进行治疗,1次/d;观察组在对照组基础上,联合静脉注射5 ml左卡尼汀进行治疗,3次/周。两组患者均连续治疗4周。比较两组患者肌酐、脑钠肽(BNP)及C-反应蛋白(CRP)等实验室指标与心指数(CI)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)等心功能指标。结果两组患者治疗前相关实验室和心功能指标比较,差异未见统计学意义(P>0.05)。观察组患者治疗后肌酐、脑钠肽(BNP)、C-反应蛋白水平及左室舒张末期内径、左室收缩末期内径皆明显低于对照组(P<0.05),治疗后心指数[(2.69±0.48)L/(min·m2)]、左室射血分数[(53.7±9.6)%]明显高于对照组[(2.34±0.35)L/(min·m2)、(48.6±8.2)%],差异有统计学意义(P<0.05)。结论左卡尼汀联合厄贝沙坦治疗终末期肾病维持性血液透析合并心功能不全,能够有效降低体内肌酐、BNP水平,改善炎症状态与心功能指标,疗效确切,值得推广应用。Objective To investigate the effect of L-carnitine combined with irbesartan on cardiac insufficiency in patients with end-stage renal disease and maintenance hemodialysis.Methods A total of 80 patients with end-stage renal disease and maintenance hemodialysis and cardiac insufficiency who were treated in Chaozhou Central Hospital from January 2019 to July 2019 were randomly divided into control group and observation group,with 40 cases in each group.The patients in the control group were treated with 150 mg of irbesartan orally once a day;in the observation group,the patients were treated with 5 ml of l-carnitine intravenously 3 times a week,based on the treatment in the control group.The patients in both groups were treated continuously for 4 weeks.The levels of creatinine,brain natriuretic peptide(BNP),C-reactive protein(CRP)and cardiac index(CI),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)were compared between the two groups.Results There were no significant differences in the laboratory or cardiac function indexes between the two groups before treatment(P>0.05).The levels of creatinine,brain natriuretic peptide(BNP),C-reactive protein,left ventricular end-diastolic diameter,and left ventricular end-systolic diameter in the observation group were significantly lower than those in the control group after treatment(P<0.05),and the heart index[(2.69±0.48)L/(min·m2)]and left ventricular ejection fraction[(53.7±9.6)%]were significantly higher than the control group[(2.34±0.35)L/(min·m2),(48.6±8.2)%],the differences were significant(P<0.05).Conclusion L-carnitine combined with irbesartan in the treatment of end-stage renal disease maintenance hemodialysis combined with cardiac insufficiency can effectively reduce the levels of creatinine and BNP in the body,improve the inflammatory status and cardiac function indicators,and it is effective and worthy of popularization.

关 键 词：左卡尼汀 厄贝沙坦 终末期肾病 维持性血液透析 心功能不全 

分 类 号：R692.5[医药卫生—泌尿科学] R541.6[医药卫生—外科学]