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目的:观察左卡尼汀治疗慢性肾衰合并冠心病/心律失常的临床疗效及其对患者氧化低密度脂蛋白(oxLDL)的影响。方法:64例慢性肾衰合并冠心病心律失常患者按入院先后顺序分为对照组和观察组各32例。对照组接受血液透析及内科常规治疗,观察组在对照组基础上加用左卡尼汀。3个月疗程结束后,比较两组患者的临床疗效,以及治疗前后左心室舒张末期内径(LVDD)、左室收缩末期内径(LVSD)、左心室射血分数(LVEF)、左室短轴缩短率(LVSF)等心功能指标和血清ox-LDL水平等治疗前后的变化。结果:两组患者治疗后各项心功能指标均较治疗前有明显改善(P<0.05),且观察组改善幅度明显大于对照组(P<0.05);治疗后观察组ox-LDL水平较治疗前明显下降(P<0.05),且显著低于对照组(P<0.05)。观察组冠心病和心律失常临床总有效率均显著高于对照组(P<0.05)。结论:左卡尼汀联合常规治疗可明显改善患者心功能,降低慢性肾衰合并冠心病患者心律失常及心绞痛的发作频率,有效降低血清ox-LDL水平。
Objective: To observe the clinical efficacy of levocarnitine and its effect on oxidized low density lipoprotein (oxLDL) in patients with chronic renal failure complicated with coronary heart disease / arrhythmia. Methods: Sixty-four patients with chronic renal failure complicated with coronary heart disease were divided into control group and observation group according to the order of admission. The control group received routine hemodialysis and medical treatment. The observation group received levocarnitine on the basis of the control group. After 3 months of treatment, the clinical efficacy and the changes of left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), left ventricular ejection fraction (LVEF) (LVSF) and other cardiac function and serum ox-LDL levels before and after treatment changes. Results: After treatment, the indexes of cardiac function in both groups were significantly improved (P <0.05), and the improvement in the observation group was significantly greater than that in the control group (P <0.05). After treatment, the levels of ox-LDL in the observation group were significantly higher than those in the treatment group Before significantly decreased (P <0.05), and significantly lower than the control group (P <0.05). The total effective rate of coronary heart disease and arrhythmia in the observation group was significantly higher than that in the control group (P <0.05). Conclusion: L-carnitine combined with conventional treatment can significantly improve cardiac function, reduce the incidence of arrhythmia and angina pectoris in patients with chronic renal failure and coronary heart disease, and effectively reduce serum ox-LDL levels.