左卡尼汀注射液联合美托洛尔片对维持性血液透析患者心功能改善临床疗效观察  

Levocarnitine injection combined with metoprolol in maintenance hemodialysis patients clinical observation on the improvement of cardiac function

作　　者：李晓红[1] 眭莉[1] 吴小刚[1] 李艳 Li Xiaohong;Sui Li;Wu Xiaogang;Li Yan(Department of Emergency,First People's Hospital,Ji'an,Jiangxi,343000,China)

机构地区：[1]江西省吉安市第一人民医院急诊科,江西吉安343000

出　　处：《当代医学》2018年第23期1-4,共4页Contemporary Medicine

基　　金：吉安市科技计划:吉市科技字(2016)4号(72)

摘　　要：目的研究分析左卡尼汀注射液联合美托洛尔片对维持性血液透析患者心功能改善的临床疗效。方法将2015年1月~2016年10月期间在本院血液透析室进行维持性血液透析治疗的113例患者,选出70例参加此项临床研究,所有选出患者均无使用β受体阻滞剂禁忌证,将其随机分成对照组和治疗组,每组35例。两组均在接受维持性血液透析每周2~3次的同时,给予降压(CCB/ACEI/ARB/α受体阻滞剂)、纠正贫血等治疗,治疗组在每次血液透析结束回血前3 min从血路管端注入0.9%氯化钠溶液10 ml+左卡尼汀1 g,同时常规给予长期口服琥珀酸酸美托洛尔缓释片。所有患者均在使用上述药品前检测心脏超声、血脑利钠肽值(BNP)、心率(HR)、血压(BP),并行6 min步行距离等各项反映心脏功能参数测定,在连续使用12个月后复查上述参数,对比两组患者上述参数变化。结果两组患者治疗前心脏超声指标比较差异无统计学意义,经治疗后患者的LVEF都有所上升,LVEDD下降,但经过左卡尼汀及美托洛尔片长期联合的治疗组比对照组的改善情况更明显,疗效更好,前后比较差异有统计学意义(P<0.05)。两组患者治疗前心率、血压以及血脑利钠肽值比较差异无统计学意义,治疗后心率、血脑利钠肽值都有所下降,但治疗组的下降更为明显,前后比较差异有统计学意义(P<0.05)。两组患者治疗前6 min步行距离平均值比较差异无统计学意义,治疗后两组患者的步行距离相比治疗前距离都有增加,但治疗组的前后步行距离增加更明显,前后差异有统计学意义(P<0.05)。对于治疗前后两组血压观察,有透析相关性低血压患者,治疗组血压较前有升高,发生透析相关性低血压次数减少。故经过血液透析后静脉注射左卡尼汀注射液联合美托洛尔片口服长期的治疗对于改善维持性血液透析患者心功能的临床疗效更好。结论左卡尼汀注射液联�Objective To study and analyze the clinical effect of Levocarnitine injection combined with metoprolol tablets on cardiac function improvement in maintenance hemodialysis patients.Methods 70 patients were selected from 113 patients who were treated with maintenance hemodialysis in our hospital's hemodialysis room from January 2015 to October 2016.All the selected patients had no contraindication of usingβ-blocker.They were randomly divided into control group and treatment group with 35 cases in each group.The control group and the treatment group were treated with CCB/ACEI/ARB/αreceptor blocker at the same time as maintenance hemodialysis three times a week to correct anemia,etc.In the treatment group,3 min was injected 0.9%saline 10 ml leucanidine 1 g at the end of each hemodialysis before the end of hemodialysis,and metoprolol succinate sustained release tablet was routinely given orally for a long time.Heart ultrasound,BNP,HRT,BP and 6 min walking distance were measured before the use of the drugs,and the parameters were reexamined after 12 months of continuous use.The changes of these parameters were compared between the two groups.Results There was no significant difference in cardiac function between the two groups before and after treatment.After treatment,LVEF increased and LVEDD decreased,but the improvement was more obvious after long-term combination of L-carnitine and metoprolol compared with the control group.There was no significant difference in heart rate,blood pressure and brain natriuretic peptide between the two groups before treatment.After treatment,the heart rate,blood pressure and blood brain natriuretic peptide decreased,but the decrease was more obvious in the treatment group.There was no significant difference in 6 min walking distance between the two groups before treatment,but the walking distance between the two groups was longer than that before treatment,but the walking distance in the treatment group was longer.Comparison of two groups of patients with changes in plasma carnitine

关 键 词：左卡尼汀 美托洛尔 维持性血液透析 心功能 

分 类 号：R459.5[医药卫生—治疗学]