摘要
目的观察沙库巴曲缬沙坦联合左卡尼汀对维持性血液透析并心力衰竭患者心功能的改善效果。方法选取2019年1月—2022年12月峨眉山市中医医院收治的60例维持性血液透析并心力衰竭患者为研究对象,按双色球随机法分为左卡尼汀组和联合缬沙坦组,各30例。左卡尼汀组患者予注射用左卡尼汀,联合缬沙坦组患者在左卡尼汀组基础上予沙库巴曲缬沙坦钠片,2组患者均持续治疗21 d。比较2组临床疗效,治疗前及治疗21 d后心功能指标[心脏指数(CI)、左心室射血分数(LVEF)、心排血量(CO)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)]、生活质量综合评定问卷-74评分及不良反应。结果联合缬沙坦组患者总有效率高于左卡尼汀组(96.67%vs.66.67%,χ^(2)=9.017,P=0.003)。治疗21 d后,2组患者CI、LVEF及CO高于治疗前,且联合缬沙坦组患者高于左卡尼汀组(P<0.05或P<0.01);2组患者血清TNF-α、IL-6、CRP水平低于治疗前,且联合缬沙坦组患者低于左卡尼汀组(P<0.05或P<0.01);2组患者心理功能、社会功能、躯体功能及物质生活评分高于治疗前,且联合缬沙坦组患者高于左卡尼汀组(P<0.01)。联合缬沙坦组患者治疗期间不良反应总发生率低于左卡尼汀组(6.67%vs.26.67%,χ^(2)=4.320,P=0.038)。结论沙库巴曲缬沙坦联合左卡尼汀可有效改善维持性血液透析并心力衰竭患者的心功能,并可减轻机体炎性反应,提高患者的生活质量,且安全性较高。
Objective To observe the improvement effect of sacubitril valsartan combined with levocarnitine on cardiac function of maintenance hemodialysis patients with heart failure.Methods A total of 60 cases of maintenance hemodialysis patients with heart failure admitted to Hospital of Traditional Chinese Medicine of Emeishan City from January 2019 to December 2022 year were selected as study subjects,and they were divided into the group A and the group B according to two-color ball randomization method,each group with 30 cases.Group A of patients were given levocarnitine for injection,and group B of patients were given sacubitril valsartan sodium tablets on the basis of the group A,and patients of the two groups were treated continuously for 21 days.Clinical efficacy,cardiac function indexes(CI,LVEF,CO),serum inflammatory factors(TNF-α,IL-6,CRP),GQOL-74 score before and after 21 days of treatment,and adverse reactions were compared between the two groups.Results The total effective rate of patients in the group B was higher than that of the group A(96.67%vs.66.67%,χ^(2)=9.017,P=0.003).After 21 days of treatment,CI,LVEF and CO in the two groups were higher than those before treatment,and patients in group B were higher than those of the group A(P<0.05 or P<0.01);Serum TNF-α,IL-6 and CRP levels in the two groups were lower than those before treatment,and patients in the group B were lower than those of the group A(P<0.05 or P<0.01);Scores of psychological function,social function,somatic function and material life in the two groups were higher than those before treatment,and patients in the group B were higher than those in the group A(P<0.01).The total incidence of adverse reactions during treatment in the group B was lower than that in the group A(6.67%vs.26.67%,χ^(2)=4.320,P=0.038).Conclusion Sacubitril valsartan combined with levocarnitine can effectively improve the cardiac function of maintenance hemodialysis patients with heart failure,and can reduce the body′s inflammatory response,improve the quality of li
作者
邹瑞
柴雪梅
杨文戈
ZOU Rui;CHAI Xuemei;YANG Wenge(Hospital of Traditional Chinese Medicine of Emeishan City,Sichuan Province,Emeishan 614200,China)
出处
《临床合理用药杂志》
2024年第6期1-4,共4页
Chinese Journal of Clinical Rational Drug Use
