左卡尼汀联合促红细胞生成素治疗肾性贫血的疗效分析

    Efficacy of L-carnitine combined with erythropoietin in the treatment of hemodialysis-induced renal anemia

      摘要
    • 摘要: 目的 探讨血液透析（HD）患者应用左卡尼汀与促红细胞生成素（EPO）联合治疗肾性贫血的疗效。方法 收集2015年1月至2016年12月入院的80例肾性贫血HD患者以随机号码表随机分为2组，每组40例，对照组患者给予EPO治疗，治疗组患者则在对照组治疗的基础上加用左卡尼汀，比较2组患者治疗前后血红蛋白、红细胞比容、血清铁蛋白与血清转铁蛋白饱和度等相关参数、总体治疗效果、左室重构与不良反应。结果 治疗组患者治疗后血红蛋白、红细胞比容、血清铁蛋白、血清转铁蛋白饱和度水平分别为（106.52±9.42）g/L、（28.17±2.55）%、（268.22±40.35）μg/L、（31.59±5.60）%均显著高于对照组的（95.72±8.29）g/L、（25.35±2.13）%、（220.07±41.94）μg/L、（26.48±4.91）%，甲状旁腺素、血磷、左心房前后径、左心室收缩期内径与左心室舒张期内径水平为（59.80±11.34）mmol/L、（1.39±0.37）mmol/L、（31.32±0.87）mm、（32.17±1.20）mm、（54.85±1.41）mm均显著低于对照组的（84.60±17.56）mmol/L、（1.77±0.45）mmol/L、（33.92±1.13）mm、（33.89±1.06）mm、（58.42±1.57）mm，存在显著差异（P<0.01）；显效率明显高于对照组，存在明显差异（P<0.05）；2组患者药物不良反应率不存在明显差异（P>0.05）。结论 肾性贫血HD患者应用左卡尼汀与EPO联合治疗的疗效显著，可明显改善贫血指标，促进心室重构，从而提升治疗效果，同时具有极高的安全性，不易发生不良反应，值得临床上大力推广与应用，给肾性贫血HD患者带来福音，对该领域治疗研究，具有深远的借鉴意义。

       

      Abstract: Objective To investigate the therapeutic effect of levocarnitine and erythropoietin (EPO) in hemodialysis patients with renal anemia.Methods Eighty patients with hemodialysis-induced renal anemia admitted from January 2015 to December 2016 were randomly divided into two groups by the random number table (n=40 in each group). The patients in the control group were treated with EPO. The patients in the treatment group were treated with levocarnitine on the basis of the control group. The hemoglobin, hematocrit value, serum ferritin, serum albumin transferrin saturation, the overall therapeutic effect, left ventricular remodeling and adverse reactions were compared between two groups.Results After treatment, the hemoglobin, hematocrit value, serum ferritin and serum albumin transferrin saturation in the treatment group were (106.52±9.42) g/L, (28.17±2.55)%, (268.22±40.35) μg/L, (31.59±5.60)%, respectively, which were significantly higher than those in the control group(95.72±8.29) g/L, (25.35±2.13)%, (220.07±41.94) μg/L, (26.48±4.91)%. parathyroid hormone, P3-, anteroposterior diameter of left atrium, left ventrianfar systolic diameter and left ventrianfar systolic diameter in the treatment group were (59.80±11.34) mmol/L, (1.39±0.37) mmol/L, (31.32±0.87) mmol/L, (32.17±1.20) mm, and (54.85±1.41) mm respectively, which were significantly lower than those in the control group(84.60±17.56) mmol/L, (1.77±0.45) mmol/L, (33.92±1.13) mmol/L, (33.89±1.06) mm, (58.42±1.57) mm (P<0.01). The significant efficiency rate in the treatment group was significantly higher than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusions The application of levocarnitine and EPO in patients with hemodialysis-induced renal anemia has significant curative effect, which can significantly improve the anemia indicators and promote ventricular remodeling, thereby enhancing the therapeutic effect, while being highly safe and not prone to adverse reactions.

       

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