左卡尼汀对持续性血液净化患者MMP-2、IL-18水平及心脏功能的影响
Clinical trial of levocarnitine on patients with continuous blood purification
楼益兰 1蒋萌 2郑雪俭3
作者信息
- 1. 兰溪市中医院 药剂科,浙江 兰溪 321100
- 2. 兰溪市中医院 临床药学,浙江 兰溪 321100
- 3. 兰溪市中医院 血透室,浙江 兰溪 321100
- 折叠
摘要
目的 探讨左卡尼汀对持续性血液净化患者的临床疗效及对患者基质金属蛋白酶2(MMP-2)、白细胞介素-18(IL-18)及心脏功能的影响,并分析临床疗效与安全性.方法 118例持续性血液净化患者,随机分为对照组和试验组,每组各59例.均给予血液透析治疗,对照组口服叶酸、B族维生素以及α-酮酸等药物,试验组在对照组基础上静脉推注左卡尼汀注射液20 mg/kg+0.9％NaCl 20 mL.2组患者1个周期均为28 d,共治疗3个周期.比较2组患者的临床疗效、治疗前后血清MMP-2、IL-18水平、心脏功能以及药物不良反应发生情况.结果 治疗后,对照组临床总有效率为84.74％,明显低于试验组的94.92％,差异有统计学意义(P <0.05).治疗后,2组患者血清MMP-2,IL-18,左心房内径(left atrial diameter,LAD),左心室舒张末期内径(left ventricular end diastolic diameter,LVDd),左心室后壁厚度(left ventricular posterior wall thickness,LVPWT),室间隔厚度(ventricular septal thickness,IVST),左心室体积指数(left ventricular volume index,LVMI)均较治疗前降低,且实验组更低于对照组( P <0.05);2组左心室射血分数(left ventricular ejection fraction,LVEF)和舒张早期和晚期峰值速度比(E/A)均较治疗前升高,且实验组更高于对照组.2组药物不良反应比较差异无统计学意义.结论 左卡尼汀能够显著降低持续性血液净化患者血清MMP-2、IL-18水平,改善心脏功能,临床疗效显著.
Abstract
Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.
关键词
左卡尼汀/持续性血液净化/基质金属蛋白酶2/白细胞介素-18/心脏功能Key words
levocarnitine/continuous blood purification/matrix metalloproteinase 2/interleukin-18/cardiac function引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据