目的 探討左卡尼汀聯(lián)合前列地爾對慢性腎功能衰竭患者合并心功能衰竭的臨床療效。方法 選取80例慢性腎功能衰竭合并心功能衰竭患者，隨機分為兩組，對照組（39例）給予前列地爾治療，觀察組（41例）給予左卡尼汀聯(lián)合前列地爾治療，觀察并記錄兩組治療前后心功能系數(shù)、腎功能指標(biāo)、SF-36量表評分及治療期間不良反應(yīng)情況，評價左卡尼汀聯(lián)合前列地爾對慢性腎功能衰竭合并心功能衰竭患者的臨床療效。結(jié)果 治療前，兩組心輸出量（CO）、心臟指數(shù)（CI）、心肌耗氧量（MVO）、射血分?jǐn)?shù)（EF）水平相比，差異無統(tǒng)計學(xué)意義；治療后，兩組CO、CI、MVO水平均降低且觀察組上述指標(biāo)值更低（P＜0.05）；治療后觀察組EF值明顯增加且高于對照組（P＜0.05），對照組EF值與治療前相比無明顯改變。治療前兩組胱抑素C（CysC）、血尿素氮（BUN）、血肌酐（SCr）水平相比，差異無統(tǒng)計學(xué)意義；治療后，兩組CysC、BUN、SCr水平均降低且觀察組上述指標(biāo)值更低（P＜0.05）。治療前，兩組SF-36量表各項評分相比，差異無統(tǒng)計學(xué)意義；治療后觀察組在生理功能、生理職能、總體健康上的評分均明顯高于對照組（P＜0.05），其余各項評分相比差異無統(tǒng)計學(xué)意義。治療期間，兩組不良反應(yīng)率差異無統(tǒng)計學(xué)意義。結(jié)論 左卡尼汀聯(lián)合前列地爾對慢性腎功能衰竭合并心功能衰竭具有較好的療效，能明顯改善患者心功能，降低心臟負(fù)荷；改善腎功能，增加腎小球濾過率；進而改善患者生活質(zhì)量，聯(lián)合用藥具有安全性，值得臨床推廣使用。

Objective To discuss the efficacy of alprostadil and levocarnitine in treatment of chronic renal failure combined with heart failure. Methods Totally 80 patients with chronic renal failure complicated with heart failure were selected, and randomly divided into two groups. The control group (39 cases) was given alprostadil. The observation group (41 cases) was given alprostadil and levocarnitine. The efficacy of alprostadil and levocarnitine in treatment of chronic renal failure combined with heart failure was evaluated by cardiac function indexes, renal function indexes, SF-36 scale score, and adverse reaction during the treatment. Results Before treatment, there was no statistical significance on CO, CI, MVO, and EF between two groups. After treatment, the CO, CI, and MVO were decreased and lower in the observation group (P< 0.05). The EF was increased in the observation group and higher than that of the control group (P< 0.05). The EF had no changes in the control group. Before treatment, there was no statistical significance on CysC, BUN, and SCr between two groups before treatment, without statistical significance. After treatment, CysC, BUN, and SCr were decreased in two groups and lower in the observation group (P< 0.05). Before treatment, there was no statistical significance on SF-36 scores between two groups. After treatment, the physiological function, physical function, and general health were higher than those of the control group (P< 0.05). There was no statistical significance on the rest of the scores. During treatment, there was no statistical significance on adverse reaction between two groups. Conclusion Alprostadil and levocarnitine had a good curative effect on chronic renal failure combined with heart failure. It could improve the heart function by reducing cardiac load, improve the renal function by increasing glomerular filtration rate and improve the quality of life with good safety. It is worthy of clinical application.