陈晖,李雄,袁飞远
CHEN Hui,LI Xiong,YYAN Feiyuan

• 1:凉山州第一人民医院内二科

摘要(Abstract)：

目的:探讨左卡尼汀对终末期肾病(ESRD)维持性血液透析(MHD)患者心脏结构和功能的影响。方法:将78例MHD患者随机分为两组,对照组予MHD、降压、纠正贫血等常规处理,观察组在此基础上应用左卡尼汀注射液,采用超声心动图观察两组患者治疗前后左室射血分数(LVEF)、左心室心肌质量指数(LVMI)、左心室舒张末内径(LVDd)以及舒张早、晚期最大血流速度比(E/A)。结果:治疗前两组患者超声心动图指标比较差异无统计学差异(P>0.05),观察组治疗后LVEF、E/A明显高于治疗前,LVMI、LVEDD明显低于治疗前,差异有统计学意义(P<0.05);对照组治疗前后上述指标无明显变化(P>0.05)。结论:左卡尼汀可明显改善ESRD MHD患者左心室肥厚,显著提高患者的心功能。
Objective: To investigate the effects of L-carnitine on cardiac structure and function in maintenance hemodialysis( MHD) patients. Methods: Seventy-eight MHD patients were randomly divided into two groups,of which the control group was given hemodialysis,blood pressure control,anemia correction and other conventional treatment,while the observation group was given L-carnitine injection besides above-mentioned treatments in the control group. Then,the echocardiography indicators were observed before and after treatment. Results: Before treatment,there were of no significant differences in the two groups in echocardiographic indices including LVEF,LVMI,LVEDD and E / A( P > 0. 05); But after treatment,the LVEF,E /A was significantly improved and LVMI and LVEDD was decreased significantly in the observation group( P < 0. 05),while the control group showed no significant change( P > 0. 05). Conclusion: The treatment of L-carnitine in maintenance hemodialysis patients can improve the left ventricular hypertrophy,and can significantly improve cardiac function.

关键词(KeyWords)： 血液透析;肥大,左心室;左卡尼汀;肾病
hemodialysis;hypertrophy,left ventricular;levocarnitine;hephrosis

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈晖,李雄,袁飞远
CHEN Hui,LI Xiong,YYAN Feiyuan

DOI: 10.19367/j.cnki.1000-2707.2015.10.037

参考文献(References)：

• [1]王萌.1 057例终末期肾脏病血液透析患者的临床流行病学分析[J].中国血液净化,2010(5):281-282.
• [2]Bellasi A,Block GA,Ferramosca E,et al.Integration of clinical and imaging data to predict death in hemodialysis patients[J].Hemodial Int,2013(1):12-18.
• [3]吕玉凤,刘必成,张晓良,等.新入血液透析患者伴发心力衰竭及其危险因素的研究[J].东南大学学报:医学版,2009(4):292-297.
• [4]陈献广,毛永辉,李靖,等.血液透析对终末期肾病患者左心室肥厚的影响[J].中国心血管杂志,2011(2):118-121.
• [5]胡晓舟,王少亭,张瑾,等.影响维持性血液透析患者预后相关因素的生存分析[J].中华全科医师杂志,2011(5):348-350.
• [6]庄海舟,沈潞华.慢性心力衰竭与心肌能量代谢[J].心血管病学进展,2004(6):466-470.
• [7]Van Bilsen M,Smeets PJ,Gilde AJ,et al.Metabolic remodelling of the failing heart:the cardiac burn-out syndrome[J].Cardiovasc Res,2004(2):218-226.
• [8]温黎青,李建飞.左卡尼汀对维持性血液透析患者左心室心肌重量的影响[J].临床荟萃,2008(23):1727-1728.
• [9]杨贤,梁培,王娟,等.左卡尼汀在维持性血液透析中的应用进展[J].中国临床药理学杂志,2013(5):383-385.
• [10]Seymour AM1 Reddy V,Bhandari S.Cardiac effects of carnitine supplementation in experimental uraemia[J].Front Biosci(Elite Ed),2013(5):834-844.
• [11]邬碧波,张黎明,梅长林,等.左卡尼汀和曲美他嗪联合治疗对维持性血液透析患者左心室重塑的影响[J].中国医师进修杂志,2010(16):8-12.
• [12]嵇宏亮,杨胜良,留永咏.左卡尼汀对维持性血液透析患者慢性心力衰竭疗效的系统评价[J].中国中西医结合肾病杂志,2012(8):722-724.
• [13]张涛.左卡尼汀的临床应用及不良反应[J].山西医药杂志,2011(21):1100-1102.

文章评论(Comment)：