L-肉碱对血液透析患者促红细胞生成素低反应性贫血和铁负荷的影响

Effect of L - carnitine therapy on erythropoietin - hyporesponsive anemia and iron overload in maintenance hemodialysis patients

目的观察静脉注射L-肉碱对维持性血液透析患者促红细胞生成素（EPO）低反应性贫血的纠正情况及对铁负荷的影响。方法选择存在促红细胞生成素低反应性贫血的患者60例，均于每次透析结束时静脉给予L-肉碱2g，疗程6个月，对比治疗前后血红蛋白、血细胞比容、血清铁、转铁蛋白饱和度、总铁结合力、血清铁蛋白及白蛋白、前白蛋白等指标。结果L-肉碱治疗6个月后血红蛋白、血细胞比容、白蛋白、前白蛋白、总铁结合力水平较治疗前明显上升（P〈0．01）。结论L-肉碱可明显改善尿毒症EPO低反应性患者的贫血状况，降低铁负荷，同时改善此类患者的营养状况。

Objective To evaluate the effects anemia and iron overload in maintenance hemodialysis of L - carnitine therapy on EPO - hyporesponsive patients. Methods Sixty maintenance hemodialysis patients with EPO - hyporesponsive anemia were infused with 2 g of L - carnitine at the end of each hemodialysis for 6 months. Hemoglobin, hematocrit, serum ferrum, TS, TBC, ferritin, serum albumin, and proalbumin were measured before and after the therapy. Results Hemoglobin, hematocrit, albumin, proalbumin, and TBC were improved significantly after the 6 months time therapy （ P 〈 0.01 ）. Conclusions L- carnitine can improve EPO - hyporesponsive anemia, reduce iron overload and improve nutritional state of the patients on maintenance hemodialysis.