摘要
目的 探讨左卡尼汀联合缬沙坦对维持性血液透析(MHD)患者左室结构和功能的影响.方法 选择42例行MHD的尿毒症患者,在常规治疗基础上加用缬沙坦80～160 mg,每天1次；左卡尼汀1.0g于每次透析结束前静脉注射,疗程6个月.根据超声心动图结果,记录患者治疗前后各项反映左室结构和功能的指标的变化,包括左室形态学指标:左室舒张末径(LVEDD)、左室收缩末径(LVESD)、室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPWT)、左室质量指数(LVMI)；左室舒张功能指标:二尖瓣口舒张早期/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)、二尖瓣血流传播速度(VP)；左室收缩功能指标:左心室射血分数(LVEF)、每搏量(SV)、二尖瓣环收缩期速度(Sa).结果 治疗6个月后,LVEDD、LVESD、IVST、LVPWT、LVMI、DT、LAV均较治疗前明显下降,E/A、VP、LVEF、SV、Sa均较治疗前明显提高(均P＜0.05).结论 左卡尼汀与缬沙坦联合应用能有效抑制MHD患者的心肌重构,同时改善心肌收缩与舒张功能.
Abstract
Objective To evaluate therapeutic effects of levocarnitine combined with Valsartan on left ventricular structure and function in maintenance hemodialysis patients. Methods Forty-two maintenance hemodialysis patients were treated by levocarnitine combined with Valsartan for 6 months. Some cardiac morphology and function indexes were determined by the tissue Doppler imaging before and after treatment,such as left ventricular end diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD) , interventricu-lar septum thickness (IVST) , left ventricular posterior wall diastolic thickness (LVPWT) , left ventricular mass index(LVMI) , the peak velocity ratio of early and late diastolic period(E/A), mitral valve E wave deceleration time (DT) , left atrium volume (LAV) , propagation velocity of mirtal flow( VP) , left ventricle ejection fraction(LVEF) , stroke volume (SV) and systolic velocity of mitral annulus(Sa). Results Compared with pretreatment, after the treatment,the cardiac indexs of LVEDD, LVESD, IVST, LVPWT, LVMI, DT and LAV apparently declined(all P<0.05) ,while the E/A, VP, LVEF, SV and Sa were significantly improved(all P < 0.05). Conclusion levocarnitine combined with Valsartan can inhibit ventricular remodeling and improve cardiac function in maintenance hemodialysis patients.
NETL
NSTL
维普
万方数据