左卡尼汀改善慢性肾衰竭血液透析心力衰竭患者心功能的疗效分析

陈澄

[摘要] 目的 分析慢性肾衰竭合并慢性心力衰竭患者血液透析后采用左卡尼汀改善心功能的效果。方法 方便选取2016年1月—2017年12月期间该院肾内科收治的慢性肾衰竭合并慢性心力衰竭患者50例，均进行血液透析治疗，随机分为观察组与对照组，对照组辅以常规治疗，观察组辅以左卡尼汀治疗，对比疗效、治疗前后患者心功能参数、结构数值的差异性。结果 观察组总疗效96.00%明显高于对照组68.00%，比较差异有统计学意义（χ2=6.639，P<0.05）;观察组治疗后心输出量（7.25±1.03）L/min、心脏指数（4.05±0.22）L/min·m2、心肌耗氧量（30.15±2.11）mL/min、心率（78.79±1.22）次/min，优于对照组，（t=5.825、9.428、5.245、5.858，P<0.05）;观察组治疗后的左室舒张末期内径（49.15±1.74）mm、室间隔厚度（10.98±0.16）mm、左室后壁厚度（10.05±0.14）mm、左室射血分数（59.01±3.21）%优于对照组，差异有统计学意义（t=5.828、4.553、4.567、4.673，P<0.05）。结论 慢性肾衰竭合并慢性心力衰竭患者血液透析后辅以左卡尼汀药物可提高治疗效果，改善心功能，安全高效，值得推广。

[关键词] 左卡尼汀;慢性腎衰竭;血液透析;心力衰竭;心功能

[中图分类号] R692          [文献标识码] A          [文章编号] 1674-0742（2019）05（b）-0109-03

[Abstract] Objective To analyze the effect of L-carnitine on cardiac function in patients with chronic renal failure and chronic heart failure after hemodialysis. Methods A total of 50 patients with chronic renal failure and chronic heart failure admitted to our hospital from January 2016 to December 2017 were convenient selected and enrolled in the study. They were randomly divided into observation group and control group， and the control group was supplemented with conventional treatment. The observation group was treated with L-carnitine to compare the efficacy， the cardiac function parameters and the structural values of the patients before and after treatment. Results The total effect of the observation group was 96.00%， which was significantly higher than that of the control group （68.00%）. The difference was significant （χ2=6.639， P<0.05）. The cardiac output （7.25±1.03） L/min and cardiac index （4.05±0.22） L/min·m2 after treatment in the observation group， myocardial oxygen consumption （30.15±2.11） mL/min， heart rate （78.79±1.22）times/min was better than the control group （t=5.825， 9.428， 5.245， 5.858， P<0.05）; observation group left ventricular end-diastolic diameter （49.15±1.74）mm， ventricular septal thickness （10.98±0.16） mm， left ventricular posterior wall thickness （10.05±0.14）mm， left ventricular ejection fraction （59.01±3.21）% in the control group， the differences were statistically significant（t=5.828， 4.553， 4.567， 4.673， P<0.05）. Conclusion Chronic renal failure combined with chronic heart failure in patients with hemodialysis supplemented with L-carnitine can improve the treatment effect， improve heart function， safe and efficient， and worth promoting.

[Key words] L-carnitine; Chronic renal failure; Hemodialysis; Heart failure; Heart function