左旋卡尼汀治疗维持性血液透析合并慢性心力衰竭临床疗效观察

目的：探讨左旋卡尼汀对维持性血液透析合并慢性心力衰竭患者心功能的影响及疗效。方法：30例维持性血液透析合并慢性心力衰竭心功能Ⅲ～Ⅳ级患者随机分为治疗组15例和对照组15例。对照组给予常规血液透析、纠正心力衰竭药物治疗，治疗组在对照纽治疗基础上透析结束后缓慢静脉注射左旋卡尼汀针1g/次，2-3次，周，疗程3个月。观察两组治疗前、后患者心功能改善情况。并于治疗前和疗程结束时测定心功能指标：左室射血分数（LVEF），心排血量（CO），左室短轴缩短率（Fs），左室舒张末期内径（LvDd）。结果：对照组显效7例，有效3例，无效5例，总有效率66.7％；治疗组显效9例，有效4例，无效2例，总有效率86.7％，疗效优于对照组（P〈0.05）。治疗组心功能明显好转，LVEF、CO、FS和LVDd较治疗前明显改善，与对照组比较，差异有统计学意义（P〈0.05）。结论：左旋卡尼汀可改善维持性血液透析合并慢性心力衰竭患者的心功能。

Karni left-hand statins on maintenance hemodialysis treatment combined with chronic heart failure patients clinical curative effect observation

objective： To explore the left-hand karni of statins on maintenance hemodialysis combined with chronic heart failure patients with cardiac function influence and curative effect. Methods 30 patients with maintenance hemodialysis combined with chronic heart failure cardiac function Ⅲ ～ Ⅳ stage were randomly divided into the treatment group and the control group in 15 cases, 15 cases. Control group give regu- lar hemodialysis, correct heart failure drug treatment, the treatment group in the control group in dialysis treatment on the basis of slow after intravenous left-hand statins karui needle 1 g/times, 2～3 times per week, treatment 3 months. Observation two groups before treatment, patients after cardiac function improvement, and in before treatment and at the end of the course of determination of cardiac function indexes, left ventricular ejection fraction（LV EF）, heart exhaust blood volume（CO ）, left ventricular short axis shorten rate（FS）, left ventricular enddiastolic diameter （LV Dd）. Results： 7 cases in control group, the effective 3 cases effectiveness and 5 cases, the total effective rate 66.7%, The treatment group （P〈9 cases, 4 cases were effective, invalid in 2 cases, the total effective rate 86.7%, the curative effect is better than the control group （P〈0.05）. The treatment group cardiac function improved significantly, LV EF, CO, FS and LVDd than before treatment significantly improved, comparing with control group, the difference was statistically significant （P〈0.05） conclusion： the left-hand karni statins can improve maintenance hemodialysis combined with chronic heart failure patients with cardiac function.