左卡尼汀联合促红细胞生成素治疗心肾贫血综合征

Effects of L-carnitine plus erythropoietin on cardio-renal-anemia syndrome

目的观察左卡尼汀(LC)联合促红细胞生成素(EPO)治疗维持性血液透析患者心肾贫血综合征(CRAS)的临床效果。方法将68例患者随机分为2组:EPO组34例,LC联合EPO组34例。EPO组仅每周血液透析后皮下注射EPO 10 000 U,LC联合EPO组每周血液透析后皮下注射EPO 10 000 U,同时每次血液透析后静脉缓慢注射LC 1.0 g。治疗3个月后比较2组患者血红蛋白(Hb)、红细胞压积(Hct)、左心室射血分数(LVEF)、左心室收缩/舒张末期内径(LVDs/d);评估患者心功能分级。结果 LC联合EPO组Hb、Hct升高较EPO组明显(P均<0.05),LVEF提高、LVDs/d缩小以及心功能改善也优于EPO组(P均<0.05)。结论 LC联合EPO治疗CRAS疗效明显优于单用EPO。

Objective To evaluate the effects of L-carnitine （LC） combining with erythropoietin（EPO） on cardiorenal-anemia syndrome （CRAS） in patients received maintenance hemodialysis. Methods Sixty-eight patients were randomly divided into two groups （n = 34, each） ： EPO group and LC ＋ EPO group. The patients in EPO group only received subcutaneous injecting EPO 10 000 U after hemodialysis oncea week,and the patients in LC ＋ EPO group received intravenous injecting LC 1.0 g after every hemodialysis and subcutaneous injecting EPO 10 000 U once a week. After three months,hemoglobin （Hb）, hematocrit （ Hct）, left ventricular ejection fraction （ LVEF）, left ventricular systolic diameter （ LVDs ）, left ventricular diastolic diameter （LVDd） and cardiac function in two groups were compared. Results Compared with EPO group, Hb, Hct, LVEF, LVDs/d and the cardiac function in LC ＋ EPO group were significantly improved （ all P 〈 0. 05 ）. Conclusions The clinical therapeutic effect of LC plus EPO for CARS in patients received maintenance hemodialysis was superior to EPO alone.