左卡尼汀对血液透析患者心功能的作用.doc

左卡尼汀对血液透析患者心功能的作用
作者:刘玉夏朱丽芹刘云启成兆强高金祥
【关键词】尿毒症
【摘要】目的探讨左卡尼汀对慢性肾衰竭透析患者心功能的作用。方法维持性血液透析患者58例,分为治疗组30例,对照组28例。治疗组于透析结束前静脉注射左卡尼汀10 g,每周3次,疗程3个月;对照组注射等量的生理盐水。用心功能检测仪测定患者每搏心输量(SV)、每分钟心搏量(CO)、心脏指数(CI)、左心功能指数(QZ)、心肌收缩力(DZ/DT)、心缩力指数(HI)。结果治疗组精神状态、体力明显改善,心肌收缩力增强,心功能指数较治疗前及对照组明显改善(P<001)。结论左卡尼汀可改善透析患者的心功能。
【关键词】心功能;尿毒症;血液透析;左卡尼汀

【Abstract】 Objective To investigate the cardiac function improving effect of Lcarnitine in hemodialysis fiftyeight patients on maintaining hemodialysis were divided into twogroups,treatment group (n=30) and control group (n=28).10 g of Lcarnitine was infused to the patients in treatment group at the end of dialysis three times a week for 3
ile normal saline was given to the control function indexes SV,CO,CI,QZ,DZ/DT and HI before and after treatment were In the treatment group,physical and mental status were significantly improved and the cardiac function was improved too (P<001)。Conclusion Lcarnitine can improve cardiac function in patients on maintaining hemodialysis patients.
【Key words】 Lcarnitine,cardiac function,hemodialysis
维持性血液透析患者在透析过程中经常出现低血压、胸闷、心悸、乏力、心律失常、甚至心绞痛或不能耐受透析等情况,特别是老年原有心脏疾患或维持性透析时间较长者。这与患者的心肌收缩力降低、心功能下降或易发生心力衰竭相关。左卡尼汀(左旋肉毒碱,Lcarnitine)是人体内存在的天然物质,在心肌氧化代谢和产生能量中起关键作用[1]。维持性血液透析患者由于摄食不足,恶心呕吐,消化吸收不良,合成减少及透析中丢失,可出现左卡尼汀缺乏,导致心肌和其他肌肉病变,影响心肌收缩力而产生诸如上述的症状和体征。我院肾内科血液透析净化室采用左卡尼汀