沙库巴曲缬沙坦联合左卡尼汀对慢性肾衰竭血液透析合并心力衰竭患者感染、肾、心症状及血液指标的影响

摘要/Abstract

摘要： 目的：研究沙库巴曲缬沙坦联合左卡尼汀对慢性肾衰竭血液透析合并心力衰竭患者感染、肾、心症状及血液指标的影响。方法：选择2020年2月至2022年12月在我院接受治疗的慢性肾衰竭血液透析合并心力衰竭患者288例作为研究对象，按随机数字表法分成观察组及对照组，每组各144例。两组患者均常规给予血液透析和对症治疗的同时，对照组患者给予沙库巴曲缬沙坦治疗，观察组在对照组用药基础上另增加左卡尼汀，两组患者均治疗3个月。对比两组患者肾功能指标、心功能指标、血液指标、药物不良反应以及感染情况。结果：治疗后，两组患者肾功能指标β2微球蛋白（β2MG）、血肌酐（Scr）、尿素氮（BUN）水平，心功能指标N末端脑钠肽前体（NT-proBNP）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）水平均低于治疗前，且观察组患者以上指标降低幅度均较对照组更为明显（P<0.05）。治疗后，两组患者肾功能指标肾小球滤过率（eGFR）水平、心功能指标左心室射血分数（LVEF）水平均高于治疗前，且观察组患者以上指标升高幅度均较对照组更为明显（P<0.05）。治疗后，两组患者血液指标血红蛋白（Hb）、转铁蛋白饱和度（TAST）、血清铁蛋白（SF）水平差异均无统计学意义（P>0.05）。观察组患者药物不良反应的总发生率是4.17%，相较于对照组的1.39%差异无统计学意义（P>0.05）。观察组患者感染率是1.39%，低于对照组的6.25%（P<0.05）。结论：应用沙库巴曲缬沙坦联合左卡尼汀治疗慢性肾衰竭血液透析合并心力衰竭患者，能有效改善患者心肾功能，降低感染的发生，且不会影响患者的血液指标，安全性较高。

关键词: font-size:medium, ">沙库巴曲缬沙坦；左卡尼汀；慢性肾衰竭；血液透析；心力衰竭；感染；症状改善；血液指标

Abstract: Objective： To study the effects of sacubitril valsartan combined with levocarnitine on infection， renal and cardiac symptoms and blood indexes of chronic renal failure hemodialysis patients with heart failure. Methods：288 chronic renal failure hemodialysis patients with heart failure treated in our hospital from February 2020 to December 2022 were selected as the study objects， and were divided into the observation group and the control group according to the random number table method， with 144 cases in each group. Both groups received routine hemodialysis and symptomatic treatment. The control group was treated with sacubitril valsartan. The observation group was supplemented with levocarnitine on the basis of the treatment of the control group. Both groups were treated for 3 months. The renal function index， cardiac function index， blood index， adverse drug reactions， and infection of the patients were compared between the two groups. Results： After treatment， the renal function indicators β2MG， Scr and BUN， cardiac function index NT-proBNP， LVEDD and LVESD levels of patients in both groups were lower than those before treatment， and the reduction in the observation group was more obvious than that of the control group (P<0.05). After treatment， the renal function index eGFR level and cardiac function index LVEF level of patients in both groups were higher than those before treatment， and the increase in the observation group was more obvious than that of the control group (P<0.05). After treatment， there were no significant differences in blood index hemoglobin (Hb)， transferrin saturation (TAST) and serum ferritin (SF) levels between the two groups (P>0.05). The overall incidence of adverse drug reactions in the observation group was 4.17%， which had no statistical significance compared with 1.39% in the control group (P>0.05). The infection rate in the observation group was 1.39%， which was lower than 6.25% in the control group (P<0.05). Conclusion：The application of sacubitril valsartan combined with levocarnitine in the treatment of chronic renal failure hemodialysis patients with heart failure can effectively improve the cardiac and renal function of patients， reduce the occurrence of infection， and will not affect the blood index of patients， and has high safety.

Key words: font-size:medium, ">Sacubitril valsartan； Levocarnitine； Chronic renal failure； Hemodialysis； Heart failure； Infection； Symptom improvement； Blood index

中图分类号:

刘俊红, 陈美自. 沙库巴曲缬沙坦联合左卡尼汀对慢性肾衰竭血液透析合并心力衰竭患者感染、肾、心症状及血液指标的影响[J]. 中国医药导刊, 2023, 25(7): 750-755.

LIU Junhong, CHEN Meizi. Effects of Sacubitril Valsartan Combined with Levocarnitine on Infection， Renal and Cardiac Symptoms and Blood Indexes of Chronic Renal Failure#br# Hemodialysis Patients with Heart Failure[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2023, 25(7): 750-755.

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