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目的探讨替米沙坦联合左卡尼汀对慢性肾功能衰竭(CRF)腹膜透析(PD)患者心脏结构及心功能的影响。方法选择80例CRF接受PD患者为研究对象,随机分为治疗组和对照组;所有患者均常规进行PD,对照组给予左卡尼汀口服液10 mL/次、3次/d,治疗组在上述基础上加替米沙坦80 mg/次、1次/d,2组均连续服用24周;采用王新房法测定治疗前后左室舒张末径(LVEDD)、左室收缩末径(LVESD)、室间隔舒张末期厚度(IVST)、二尖瓣口舒张早/晚期最大血流速度比(E/A)、二尖瓣E峰减速时间(DT)、左心房容积(LAV)、左室射血分数(LVEF)、每搏量(SV)。结果 2组LVEDD、LVESD、IVST均降低,治疗组优于对照组(P<0.05);2组E/A升高,DT、LAV降低,治疗组优于对照组(P<0.05);2组LVEF、SV均较治疗前升高,治疗组优于对照组(P<0.05)。结论PD患者常伴随左心室肥大、心肌收缩力降低、心功能衰竭等,已成为PD患者重要的死亡原因,左卡尼汀联合替米沙坦可有效抑制PD患者心肌重构、改善心肌收缩及舒张功能,从而减少心血管疾病发生的风险。
Objective To investigate the effects of telmisartan combined with levocarnitine on cardiac structure and cardiac function in patients with chronic renal failure (CRF) peritoneal dialysis (PD). Methods Eighty patients with PD were enrolled in this study. Patients were randomly divided into treatment group and control group. PD was given routinely in all the patients. The control group was treated with L-carnitine 10 mL / On the basis of above, telmisartan 80 mg / time, once / d, two groups were taken continuously for 24 weeks; before and after treatment with the method of Wang Xin Fang measured left ventricular diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) IVST, E / A, mitral E-Deceleration time, left atrial volume, Blood fraction (LVEF), stroke volume (SV). Results The LVEDD, LVESD and IVST in the two groups were significantly lower than those in the control group (P <0.05). The E / A levels in the two groups were increased, while the levels of DT and LAV in the two groups were lower than those in the control group (P <0.05) LVEF, SV were higher than before treatment, the treatment group was better than the control group (P <0.05). Conclusion PD patients often accompanied by left ventricular hypertrophy, decreased myocardial contractility, heart failure, has become an important cause of death in patients with PD, levocarnitine combined with telmisartan can effectively inhibit myocardial remodeling in patients with PD, improve myocardial contractility and Diastolic function, thereby reducing the risk of cardiovascular disease.