左旋卡尼汀对维持性血液透析患者低血压和肌肉痉挛疗效观察.docVIP

左旋卡尼汀对维持性血液透析患者低血压和肌肉痉挛疗效观察 　　【摘要】目的：观察静脉补充左旋卡尼汀对血液透析患者透析中低血压、肌肉痉挛的影响和血浆游离肉碱浓度变化。方法：将维持性血液透析的患者60例，随机分为治疗组和对照组各30例；每次透析结束后，治疗组左旋卡尼汀1.0 g加15 ml生理盐水溶液静脉注射，对照组注射等量的生理盐水，12周后观察比较患者治疗前后低血压、肌肉痉挛的发生情况和血浆游离肉碱浓度。结果：治疗组注射左旋卡尼汀明显降低患者透析中低血压和肌肉痉挛的发生率，显著提高患者的血浆游离肉碱浓度(P0.01)。结论：左旋卡尼汀可安全有效地治疗维持性血液透析患者肉碱缺乏症，改善患者低血压和肌肉痉挛症状。 　　【关键词】左旋卡尼汀；维持性血液透析；低血压；肌肉痉挛 　　文章编号：1009-5519（2007）18-2702-02 中图分类号：R45 文献标识码：A 　　Observation of the therapeutic effects of L-carnitine in hypotension and muscle spasm in maintenance hemodialysis patients 　　YAO Li-qun，HUA Yun，XIANG Cheng-xi 　　 (Blood Purification Center，The Affiliated Hospital of Jiangsu University，Jiangsu 212003，China) 　　【Abstract】Objective：To observe the effects of intravenous L-carnitine on hypotension.muscle spasm and variance ofplasma free carnitine level in maintenance hemodialysis patients.Methods：Sixty patients accepting maintenance hemodialysis in the blood purification center were randomly divided into two groups:treatment group(n=30)，control group(n=30).In treatment group，L-carnitine 1g was infused to the patients at the end of each dialysis treatment for 12 weeks，while normal saline was given to the control group.The incidence of hypotension. muscle spasm and variance ofplasma free carnitine level were observed and compared.Results：Intravenous L-carnitine could significantly decrease the incidences of hypotension. muscle spasm，and increase plasma free carnitine level(P0.01).Conclusion：Treatment of L-carnitine is safe and effective on carnitine deficiency inmaintenance hemodialysis patients and decreases the incidences of hypotension. muscle spasm，and can be applied in the clinic. 　　【Key words】L-carnitine；Maintenance hemodialysis；Hypotension；Muscle spasm 　　 　　1 对象和方法 　　 　　1．1 研究对象：从本中心维持性血透患者中选取符合条件者60例，原发病为慢性肾小球肾炎44例，原发性高血压10例，糖尿病4例，多囊肾2例。其入选标准：规律血透3个月以上，无顽固性高血压，无严重的继发性甲状旁腺机能亢进，血糖控制良好；透析间期体重增长5%，病情相对稳定，近期无出血、严重感染、手术、心力衰竭者。 　　1．2 分组：将患者随机分为对照组和治疗组各30例。对照组男18例，女12例，年龄28~61岁，平均（38±12.6）岁，血透8~62个月，每周2~3次，每次4~5小时。治疗组男16例，女14例