左卡尼汀联合低温可调钠透析在透析低血压中的应用

目的 观察左卡尼汀联合低温可调钠透析治疗透析低血压的疗效.方法 32例维持性血液透析（MHD）患者,采用前瞻性自身配对研究,先后给予常规血透（A组）、左卡尼汀联合低温可调钠透析（B组）各6个月,共12个月.观察患者低血压发生率、平均动脉压水平、血清钠浓度、尿素清除率、C反应蛋白以及内瘘闭塞和心血管事件发生率.结果 两组患者透析后平均动脉压降低.与A组比较,B组低血压及症状性低血压发生率明显降低（P〈0.05）,内瘘闭塞及心血管事件发生率下降（P〈0.05）,C反应蛋白明显下降（P〈0.05）.患者透析前后血清钠水平及尿素氮清除率比较差异无统计学意义.结论 应用左卡尼汀联合低温可调钠透析可有效改善透析中低血压的发生率,减少内瘘闭塞及心血管事件发生率,并能改善微炎症状态.

Effect of levocarnitine and adjustable sodium concentration at low temperature on hypotension in dialysis

Objective To observe the effect of levocarnitine combined with hypothermia adjustable sodium on hypotension in dialysis. Methods Thirty-two maintenance hemodialysis patients were given routine hemodialysis （group A）and levocarnitine combined with hypothermia adjustable sodium dialysis （group B ）in succession respectively six months（ using self-matched pair study ）. The incidence rate of hypotension, mean arterial pressure, serum sodium concentration, urea clearance rate, C reactive protein, incidence of fistula occlusion and cardiovascular events were observed. Results After dialysis, the patients＇ mean arterial pressure of the 2 groups decreased; there were significant
differences in C reactive protein,incidence of hypotension, fistula occlusion and cardiovascular events between the 2 groups（ P 〈 0. 05 ）. There was no significant difference before and after dialysis in the serum sodium concentration and urea clearance rate. Conclusion Levocarnitine combined with hypotherrnia adjustable sodium dialysis at low temperature can decrease the incidence of hypotension,fistula occlusion and cardiovascular events effectively,improve the micro-inflammatory state.