左卡尼汀联合缬沙坦对维持性血液透析患者左室结构和功能的影响  

The therapeutic effects of levocarnitine combined with Valsartan on left ventricular structure and function in maintenance hemodialysis patients

作　　者：李增男[1] 杨晴[1] 李迪[1] 孙高中[1] 张人丹[1] 

机构地区：[1]中国人民解放军第100医院心内科,江苏苏州215007

出　　处：《苏州大学学报（医学版）》2012年第5期696-699,共4页Suzhou University Journal of Medical Science

摘　　要：目的探讨左卡尼汀联合缬沙坦对维持性血液透析(MHD)患者左室结构和功能的影响。方法选择42例行MHD的尿毒症患者,在常规治疗基础上加用缬沙坦80～160 mg,每天1次;左卡尼汀1.0 g于每次透析结束前静脉注射,疗程6个月。根据超声心动图结果,记录患者治疗前后各项反映左室结构和功能的指标的变化,包括左室形态学指标:左室舒张末径(LVEDD)、左室收缩末径(LVESD)、室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPWT)、左室质量指数(LVMI);左室舒张功能指标:二尖瓣口舒张早期/晚期最大血流速度比(E/A)、二尖瓣E峰减速时间(DT)、左心房容积(LAV)、二尖瓣血流传播速度(VP);左室收缩功能指标:左心室射血分数(LVEF)、每搏量(SV)、二尖瓣环收缩期速度(Sa)。结果治疗6个月后,LVEDD、LVESD、IVST、LVPWT、LVMI、DT、LAV均较治疗前明显下降,E/A、VP、LVEF、SV、Sa均较治疗前明显提高(均P<0.05)。结论左卡尼汀与缬沙坦联合应用能有效抑制MHD患者的心肌重构,同时改善心肌收缩与舒张功能。Objective To evaluate therapeutic effects of levocarnitine combined with Valsartan on left ventricular structure and function in maintenance hemodialysis patients.Methods Forty-two maintenance hemodialysis patients were treated by levocarnitine combined with Valsartan for 6 months.Some cardiac morphology and function indexes were determined by the tissue Doppler imaging before and after treatment,such as left ventricular end diastolic dimension（LVEDD）,left ventricular end systolic dimension（LVESD）,interventricular septum thickness（IVST）,left ventricular posterior wall diastolic thickness（LVPWT）,left ventricular mass index（LVMI）,the peak velocity ratio of early and late diastolic period（E/A）,mitral valve E wave deceleration time（DT）,left atrium volume（LAV）,propagation velocity of mirtal flow（VP）,left ventricle ejection fraction（LVEF）,stroke volume（SV） and systolic velocity of mitral annulus（Sa）.Results Compared with pretreatment,after the treatment,the cardiac indexs of LVEDD,LVESD,IVST,LVPWT,LVMI,DT and LAV apparently declined（allP0.05）,while the E/A,VP,LVEF,SV and Sa were significantly improved（allP0.05）.Conclusion levocarnitine combined with Valsartan can inhibit ventricular remodeling and improve cardiac function in maintenance hemodialysis patients.

关 键 词：左卡尼汀 缬沙坦 维持性血液透析 左室重构 心脏功能 

分 类 号：R541.9[医药卫生—心血管疾病] R692.5[医药卫生—内科学]