摘要
目的探讨尿毒症行维持性血液透析患者应用左卡尼汀后营养状况和心功能改善情况。方法尿毒症患者63例,其中34例应用左卡尼汀者为观察组,29例未应用左卡尼汀者为对照组,2组血液透析治疗均3次/周,观察组于每次透析结束后静脉注射左卡尼汀1g,疗程3个月。分别于治疗前及治疗后测定2组总蛋白、白蛋白、前白蛋白、血红蛋白水平,行心脏彩超评价左室射血分数(left ventricular ejection fraction,LVEF)、左心室短轴缩短率(fractional shortening,FS)、每搏量(stroke volume,SV)、舒张期早期及晚期二尖瓣血流速度E峰与A峰比值(E/A)。结果观察组治疗后总蛋白[(67.56±0.96)g/L]、白蛋白[(35.65±1.04)g/L]、前白蛋白[(0.32±0.11)g/L]、血红蛋白水平[(96.24±1.89)g/L]均高于治疗前[(61.29±1.55)、(30.41±0.82)、(0.24±0.05)、(78.76±0.65)g/L](P<0.05),且高于对照组治疗后[(63.17±1.07)、(31.21±0.73)、(0.26±0.07)、(84.79±0.9)g/L](P<0.05);观察组治疗后LVEF[(65.68±0.62)%]、FS[(38.24±0.36)%]、SV[(65.22±0.56)mL]、E/A(1.27±0.01)高于治疗前[(56.40±0.63)%、(35.47±0.50)%、(54.78±0.46)mL、0.89±0.09](P<0.05),且高于对照组治疗后[(62.34±0.30)%、(36.20±0.71)%、(57.21±0.91)mL、0.95±0.03](P<0.05)。结论行血液透析治疗尿毒症患者应用左卡尼汀可明显改善营养状况和心功能。
Objective To investigate the effect of L-carnitine on nutritional markers and cardiac function in maintenance hemodialysis patients with uremia. Methods In 63 maintenance hemodialysis patients with uremia, 34 patients received L-carnitine intravenous injection （observation group） and 29 were not treated by L-carnitine （control group）. All patients received regular hemodialysis three times per week. Observation group received 1 g L-carnitine intravenous injection after hemodialysis, totally for three months. The levels of total protein, albumin, pre-albumin and hemoglobin were detected before and after treatment. The left ventricular ejection fraction, fractional shortening, stroke volume and E/A were determined by color Doppler. Results After treatment, the serum levels of total protein （（67.56±0.96） g/L）, albumin （（35.65± 1. 04） g/L）, pre-albumin （（0. 32±0. 11） g/L） and hemoglobin （（96.24 ± 1.89） g/L） were significantly higher than those before treatment （（61. 29± 1. 55）, （30. 41±0. 82）, （0. 24±0. 05）, （78. 76±0. 65） g/L） in observation group （P〈0.05）, and were higher than those in control group after treatment （（63.17±1.07）, （31.21±0.73）, （0.26±0.07）, （84. 79±0. 9） g/L） （P〈0.05）. The left ventricular ejection fraction （（65. 68±0. 62）±）, fractional shortening （（38.24±0.36）%）, stroke volume （（65.22±0.56） mL） and E/A （1.27±0.01） after treatment were significantly higher than those before treatment （（56. 40 ± 0. 63） %, （35. 47 ± 0. 50） %, （54. 78±0. 46） mL, 0. 89±0. 09） （P〈0.05） in observation group, and significantly higher in control group after treatment （（62. 34 ± 0.30）%, （36.20±0.71）%, （57.21±0.91） mL, 0. 95±0. 03） （P〈0.05）. Conclusion L-carnitine can improve the nutritional status and cardiac function in maintenance hemodialysis patients with uremia.
出处
《中华实用诊断与治疗杂志》
2015年第12期1239-1241,共3页
Journal of Chinese Practical Diagnosis and Therapy
