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目的探讨左卡尼汀(左旋肉碱)对糖尿病肾病(DN)血液透析患者贫血状态及心功能的影响。方法 46例DN血液透析患者,随机分为实验组与对照组,各23例。对照组采用常规药物治疗,实验组在对照组基础上采用左卡尼汀治疗。治疗后比较两组患者贫血状态[血红白蛋白(Hb)、白蛋白(Alb)及红细胞压积(Hct)]及心功能指标[心脏指数(CI)、每分钟心搏量(CO)、每搏输出量(SV)及左室射血分数(LVEF)]的变化。结果治疗前两组患者Hb、Alb、Hct水平比较差异无统计学意义(P>0.05);治疗后两组Hb、Alb、Hct水平均显著高于治疗前,且实验组高于对照组,差异有统计学意义(P<0.05)。治疗前实验组CI(2.0±0.7)L/min、CO(3.1±0.8)L/min、SV(41.2±7.8)ml、LVEF(35.8±9.2)%,对照组分别为(1.9±0.6)L/min、(3.0±0.8)L/min、(41.3±8.6)ml、(35.6±9.3)%;治疗后实验组CI(3.3±0.5)L/min,CO(4.2±1.1)L/min、SV(55.1±8.4)ml、LVEF(69.9±10.1)%,对照组分别为(2.2±0.6)L/min、(3.2±0.7)L/min、(46.8±8.7)ml、(58.3±9.8)%;治疗前两组患者CI、CO、SV、LVEF比较差异无统计学意义(P>0.05),治疗后两组CI、CO、SV及LVEF水平均显著高于治疗前,且实验组高于对照组,差异有统计学意义(P<0.01)。结论左卡尼汀可有效改善DN患者贫血状态,增强其心功能,维持患者正常代谢,遏制病情恶化,临床疗效值得肯定。
Objective To investigate the effect of levocarnitine (L-carnitine) on anemia and cardiac function in patients with diabetic nephropathy (DN) hemodialysis. Methods 46 cases of DN hemodialysis patients were randomly divided into experimental group and control group, 23 cases each. The control group was treated with conventional drugs. The experimental group was treated with levocarnitine on the basis of the control group. After treatment, the levels of anemia (Hb, Alb and Hct) and cardiac function index (CI) and stroke volume (CO) were compared between the two groups Stroke volume (SV) and left ventricular ejection fraction (LVEF)] changes. Results There was no significant difference in Hb, Alb and Hct levels between the two groups before treatment (P> 0.05). The levels of Hb, Alb and Hct in the two groups after treatment were significantly higher than those before treatment, and the experimental groups were higher than the control group There was statistical significance (P <0.05). Before treatment, the mean arterial blood pressure was (2.0 ± 0.7) L / min, CO (3.1 ± 0.8) L / min and SV were 41.2 ± 7.8 and 35.8 ± 9.2% (3.3 ± 0.5) L / min, CO (4.2 ± 1.1) L / min, (36.0 ± 0.8) (2.2 ± 0.6) L / min, (3.2 ± 0.7) L / min, (46.8 ± 8.7) ml and (58.3 ± 9.8) %. There was no significant difference in CI, CO, SV and LVEF between the two groups before treatment (P> 0.05). After treatment, the levels of CI, CO, SV and LVEF in both groups were significantly higher than those before treatment, The control group, the difference was statistically significant (P <0.01). Conclusion L-carnitine can effectively improve the state of anemia in patients with DN, enhance its cardiac function, maintain normal metabolism, and prevent the disease from deteriorating. The clinical efficacy is worthy of recognition.