左卡尼汀对维持性血液透析低血压患者的临床疗效观察
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摘要
目的探讨左卡尼汀对维持性血液透析低血压患者的临床疗效。方法选取浙江省衢州市人民医院收治的64例维持性血液透析低血压患者,随机分成对照组和治疗组,每组32例,在常规血液透析后,对照组予促红细胞生成素治疗,治疗组在此基础上再予注射用左卡尼汀治疗,检测治疗前后血压、血红蛋白、尿素清除率、C应应蛋白(CRP)水平的变化及低血压、内瘘闭塞、心血管事件等发生率。结果与治疗前比较,2组血压及血红蛋白水平、尿素清除率均升高(P<0.05);CRP水平降低(P<0.05);低血压、内瘘闭塞、心血管事件等发生率均降低(P<0.05);与对照组比较,治疗组收缩压、最低收缩压及血红蛋白水平、尿素清除率较高(P<0.05),CRP水平较低(P<0.05);低血压、内瘘闭塞、心血管事件等发生率均较低(P<0.05);临床疗效较高(P<0.05)。结论左卡尼汀可有效降低维持性血液透析患者低血压的发生,有较好的临床疗效,且安全性高。
Objective To investigate effect of levocarnitine on maintainance hemodialysis in patients with hypotension. Methods 64 cases with continuous hemodialysis hypotension were randomly divided into control group and treatment group,32 cases in each group. Patients in the control group were treated with erythropoietin treatment after regular hemodialysis,and the treatment group based on the control group with levocarnitine. Blood pressure,hemoglobin,urea clearance rate,hypotension and changes of C-reactive protein( CRP),arteriovenous fistula occlusion and cardiovascular events incidence were compared after the treatment. Results Compared with before treatment,the incidence of two groups of blood pressure and hemoglobin levels were significantly increased( P < 0. 05) and CRP levels decreased( P < 0. 05),hypotension,arteriovenous fistula occlusion and cardiovascular events rate were decreased( P < 0. 05); compared with the control group,systolic blood pressure and minimum systolic blood pressure and hemoglobin levels of treatment group were higher( P < 0. 05) and CRP levels were lower( P < 0. 05),the incidence of hypotension,arteriovenous fistula occlusion and cardiovascular events were lower( P < 0. 05),the clinical curative effect was higher( P < 0. 05). Conclusion Levocarnitine can effectively reduce the occurrence of hypotension in hemodialysis patients continuously,with good clinical efficacy and safety.
Objective To investigate effect of levocarnitine on maintainance hemodialysis in patients with hypotension. Methods 64 cases with continuous hemodialysis hypotension were randomly divided into control group and treatment group,32 cases in each group. Patients in the control group were treated with erythropoietin treatment after regular hemodialysis,and the treatment group based on the control group with levocarnitine. Blood pressure,hemoglobin,urea clearance rate,hypotension and changes of C-reactive protein( CRP),arteriovenous fistula occlusion and cardiovascular events incidence were compared after the treatment. Results Compared with before treatment,the incidence of two groups of blood pressure and hemoglobin levels were significantly increased( P < 0. 05) and CRP levels decreased( P < 0. 05),hypotension,arteriovenous fistula occlusion and cardiovascular events rate were decreased( P < 0. 05); compared with the control group,systolic blood pressure and minimum systolic blood pressure and hemoglobin levels of treatment group were higher( P < 0. 05) and CRP levels were lower( P < 0. 05),the incidence of hypotension,arteriovenous fistula occlusion and cardiovascular events were lower( P < 0. 05),the clinical curative effect was higher( P < 0. 05). Conclusion Levocarnitine can effectively reduce the occurrence of hypotension in hemodialysis patients continuously,with good clinical efficacy and safety.
引文
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[12]鲁庆红,石明,李益明,等.百令胶囊对蔗糖铁致血液透析肾性贫血患者氧化应激的干预作用[J].中国中西医结合肾病杂志,2014,15(12):1102-1103.
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[15]杨贤,梁培,王娟,等.左卡尼汀在维持性血液透析中的应用进展[J].中国临床药理学杂志,2013,29(5):383-385.
[2]穆欣,李娟,穆琢莹,等.血液透析病人希望水平及其影响因素的研究进展[J].护理研究,2015,29(12):4488-4491.
[3]雷兴平,周建芳,陆晓艳.程序超滤对容量负荷过多透析患者低血压和痉挛的影响[J].中国中西医结合肾病杂志,2014,15(10):894.
[4]马艳艳,杨艳玲.原发性肉碱缺乏症与心肌病[J].中国实用儿科杂志,2014,29(10):738-741.
[5]中华中医药学会.慢性肾衰竭诊疗指南[J].中国中医药现代远程教育,2011,9(9):132-133.
[6]冯宏汉,舒治娥.加味参麦颗粒治疗血液透析中低血压68例[J].湖北中医杂志,2015,37(9):50.
[7]杨洪莹,王铠.血液透析中相对血容量与血压的相关性[J].国际移植与血液净化杂志,2013,11(6):25-27.
[8]刘阳,刘志坚.低温可调钠透析在透析患者并发低血压中应用的效果评价[J].中国实用护理杂志,2014,30(3):28-29.
[9]王慧敏,李光来.左卡尼汀在缺血性脑血管病治疗中的应用前景[J].中西医结合心脑血管病杂志,2014,12(11):1377-1379.
[10]何翠嫦,蒙家敏,韦启麒.左卡尼汀维持性血液透析患者中的应用进展概况[J].中国伤残医学,2014,22(11):283-284.
[11]常淑平,王韫芳,杨冉,等.左卡尼汀治疗老年维持性血液透析低血压120例[J].中国药业,2015,24(9):75-76.
[12]鲁庆红,石明,李益明,等.百令胶囊对蔗糖铁致血液透析肾性贫血患者氧化应激的干预作用[J].中国中西医结合肾病杂志,2014,15(12):1102-1103.
[13]李自如,高彩云,袁军.偏头痛患者血清C-反应蛋白水平的变化[J].中国老年学杂志,2014,34(19):5568-5569.
[14]鲁庆红,丁国华,石明,等.左卡尼汀对血液透析患者氧化应激状态的影响[J].实用临床医学,2014,15(2):32-34.
[15]杨贤,梁培,王娟,等.左卡尼汀在维持性血液透析中的应用进展[J].中国临床药理学杂志,2013,29(5):383-385.