陳澄

[摘要] 目的 分析慢性腎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 方便選取2016年1月—2017年12月期間該院腎內(nèi)科收治的慢性腎衰竭合并慢性心力衰竭患者50例，均進行血液透析治療，隨機分為觀察組與對照組，對照組輔以常規(guī)治療，觀察組輔以左卡尼汀治療，對比療效、治療前后患者心功能參數(shù)、結(jié)構(gòu)數(shù)值的差異性。結(jié)果 觀察組總療效96.00%明顯高于對照組68.00%，比較差異有統(tǒng)計學(xué)意義（χ2=6.639，P<0.05）;觀察組治療后心輸出量（7.25±1.03）L/min、心臟指數(shù)（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，優(yōu)于對照組，（t=5.825、9.428、5.245、5.858，P<0.05）;觀察組治療后的左室舒張末期內(nèi)徑（49.15±1.74）mm、室間隔厚度（10.98±0.16）mm、左室后壁厚度（10.05±0.14）mm、左室射血分?jǐn)?shù)（59.01±3.21）%優(yōu)于對照組，差異有統(tǒng)計學(xué)意義（t=5.828、4.553、4.567、4.673，P<0.05）。結(jié)論 慢性腎衰竭合并慢性心力衰竭患者血液透析后輔以左卡尼汀藥物可提高治療效果，改善心功能，安全高效，值得推廣。

[關(guān)鍵詞] 左卡尼汀;慢性腎衰竭;血液透析;心力衰竭;心功能

[中圖分類號] R692? ? ? ? ? [文獻標(biāo)識碼] A? ? ? ? ? [文章編號] 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