基于炎性因子、NT-proBNP分析复方α-酮酸片联合左卡尼汀对慢性肾衰竭合并心力衰竭患者的临床价值  

Clinical Value of Compound α-Ketoic Acid Tablets Combined with L-Carnitine in Patients with Chronic Renal Failure Complicated with Heart Failure Was analyzed Base on Inflammatory Factors and N-terminal Pro-Brain Natriuretic Peptide

作　　者：王天舒 张静静 徐亚光[1] WANG Tianshu;ZHANG Jingjing;XU Yaguang(Department of Nephrology,Second People's Hospital of Liaocheng City,Liaocheng,Shandong 252600,China)

机构地区：[1]聊城市第二人民医院肾内科,山东聊城252600

出　　处：《岭南心血管病杂志》2023年第5期510-514,共5页South China Journal of Cardiovascular Diseases

基　　金：聊城市卫生科技计划项目(项目编号:2019-WJZD085)。

摘　　要：目的基于炎性因子、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)指标水平变化分析复方α-酮酸片联合左卡尼汀对慢性肾衰竭(chronic renal failure,CRF)合并心力衰竭(heart failure,HF)患者的临床价值。方法以2019年9月至2020年11月间聊城市第二人民医院接诊的165例CRF伴HF患者为研究对象展开研究,经随机数字表分组法将所有患者随机分为研究组(n=82)及对照组(n=83),对照组仅使用左卡尼汀治疗,研究组在其基础上联用复方α-酮酸片治疗,对比两组患者血压、血糖、血红蛋白、NT-proBNP、炎性因子及其他心功能指标。结果治疗结束后两组患者的NT-proBNP、炎性因子浓度和治疗前相比均有所改善,且研究组的NT-proBNP、炎性因子浓度均低于对照组,差异有统计学意义(P<0.001)。治疗后两组患者左心室射血分数(left ventricular ejection fraction,LVEF)、心脏指数(cardiac index,CI)、心排血量(cardiac output,CO)较治疗前均明显升高,左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)较治疗前均明显降低,差异有统计学意义(均P<0.05)。治疗后观察组患者LVEF、CI、CO均高于对照组,LVEDD低于对照组,差异有统计学意义(P<0.001)。和对照组相比,研究组患者的治疗总有效率明显更高,差异有统计学意义(P<0.05)。研究组患者随访1年的复发率显著低于对照组,差异有统计学意义(7.6%vs.22.78%,P=0.008)。结论CRF合并HF患者联合应用复方α-酮酸片及左卡尼汀效果明显,能有效改善患者的各项心功能指标,减轻患者炎性反应,降低复发率,具有良好的经济及社会价值,值得临床推广。Objectives To analyze the clinical value of compoundα-ketoic acid tablets combined with L-carnitine in patients with chronic renal failure(CRF)complicated with heart failure(HF)based on the changes of inflammatory factors and N-terminal pro-brain natriuretic peptide(NT-proBNP)indexes.Methods A total of 165 patients with CRF and HF admitted to the Department of Nephrology of Second People's Hospital of Liaocheng City from September 2019 to November 2020 were selected as research objects.All the patients were randomly divided into study group(n=82)and control group(n=83)by random number table.Control group was treated with only L-carnitine.Study group was treated with compound α-ketoic acid tablets base on the treatment of control group.The effects of blood pressure,blood glucose,hemoglobin,NT-proBNP,inflammatory factors and other cardiac function indexes were compared between the two groups.Results After the end of treatment,the concentrations of NT-proBNP and inflammatory factors in the two groups were improved compared with those before treatment,and the concentrations of NT-proBNP and inflammatory factors in study group decreased significantly than those in control group(P<0.001).After treatment,the left ventricular ejection fraction(LVEF),cardiac index(CI)and cardiac output(CO)in the two groups increased significantly than those before treatment,while left ventricular end-diastolic diameter(LVEDD)decreased significantly than that before treatment(all P<0.05).Comparison between groups after treatment showed that LVEF,CI and CO in study group increased significantly than those in control group,LVEDD decreased significantly than that in control group,the differences were statistically significant(P<0.001).The total effective rate of study group increased significantly than that of control group(P<0.05).The recurrence rate of patients in study group decreased significantly than that in control group at 1 year follow-up(7.6%vs.22.78%),with statistical significance(P=0.008).Conclusions The combined application of

关 键 词：心力衰竭 慢性肾衰竭 复方Α-酮酸片 左卡尼汀 氨基末端脑钠肽前体 炎症因子 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]