左卡尼汀联合低温可调钠透析在透析低血压中的应用  

Effect of levocarnitine and adjustable sodium concentration at low temperature on hypotension in dialysis

作　　者：周惠[1] 邢昌赢[2] 陈连华[1] 

机构地区：[1]南京医科大学附属淮安第一医院肾内科,江苏淮安223300 [2]南京医科大学第一附属医院肾内科,南京210029

出　　处：《实用药物与临床》2013年第10期899-901,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察左卡尼汀联合低温可调钠透析治疗透析低血压的疗效。方法 32例维持性血液透析(MHD)患者,采用前瞻性自身配对研究,先后给予常规血透(A组)、左卡尼汀联合低温可调钠透析(B组)各6个月,共12个月。观察患者低血压发生率、平均动脉压水平、血清钠浓度、尿素清除率、C反应蛋白以及内瘘闭塞和心血管事件发生率。结果两组患者透析后平均动脉压降低。与A组比较,B组低血压及症状性低血压发生率明显降低(P<0.05),内瘘闭塞及心血管事件发生率下降(P<0.05),C反应蛋白明显下降(P<0.05)。患者透析前后血清钠水平及尿素氮清除率比较差异无统计学意义。结论应用左卡尼汀联合低温可调钠透析可有效改善透析中低血压的发生率,减少内瘘闭塞及心血管事件发生率,并能改善微炎症状态。Objective To observe the effect of levocarnitine combined with hypothermia adjustable sodium on hypotension in dialysis. Methods Thirty-two maintenance hemodialysis patients were given routine hemodialysis （group A）and levocarnitine combined with hypothermia adjustable sodium dialysis （group B ）in succession respectively six months（ using self-matched pair study ）. The incidence rate of hypotension, mean arterial pressure, serum sodium concentration, urea clearance rate, C reactive protein, incidence of fistula occlusion and cardiovascular events were observed. Results After dialysis, the patients＇ mean arterial pressure of the 2 groups decreased; there were significant differences in C reactive protein,incidence of hypotension, fistula occlusion and cardiovascular events between the 2 groups（ P 〈 0. 05 ）. There was no significant difference before and after dialysis in the serum sodium concentration and urea clearance rate. Conclusion Levocarnitine combined with hypotherrnia adjustable sodium dialysis at low temperature can decrease the incidence of hypotension,fistula occlusion and cardiovascular events effectively,improve the micro-inflammatory state.

关 键 词：低温透析 可调钠透析 左卡尼汀 透析低血压 微炎症状态 

分 类 号：R459.5[医药卫生—治疗学]