左卡尼汀治疗血液透析患者肾性贫血的荟萃分析

Meta-analysis of levocarnitine for hemodialysis patients with renal anemia

目的系统评价左卡尼汀治疗血液透析患者肾性贫血的临床疗效和安全性。方法计算机检索中国期刊全文数据库、万方数据库以及维普网,收集有关左卡尼汀治疗血液透析患者肾性贫血的随机对照试验,用Cochrane Handbook5.0推荐的文献质量评价标准,评价纳入的研究;用RevMan 5.0软件进行统计学处理。结果共纳入11项随机对照试验研究,共包括452例透析患者。Meta分析结果显示:与单独使用重组人促红细胞生成素相比,联用左卡尼汀能够显著提高患者的血红蛋白水平[WMD=12.88,95%CI(8.01,17.75),P<0.00001]及红细胞压积[WMD=3.75,95%CI(2.36,5.13),P<0.00001];同时,联用左卡尼汀能够显著减少血液透析患者高血压的发生率[RR=0.34,95%CI(0.20,0.59)]。结论左卡尼汀对血透所致的肾性贫血有益。

Objective To evaluate the efficacy and safety of levocarnitine for hemodialysis patients with renal anemia. Methods Randomized controlled trials （RCTs） involving levocarnitine in the treatment of hemodialysis patients with renal anemia were searched and identified from CNKI, Wangfang Data and VIP. The methodological quality of the included RCTs was assessed according to the standard of the Cochrane Handbook 5.0, and data analyses were performed with Cochrane Collaboration＇s RevMan 5.0. Results A total of 11 RCTs involving 452 patients were included. The results of Meta - analyses showed that： Efficacy： there were significant differences between levocarnitine combined with rHuEPO and rHuEPO alone in Hb [WMD = 12. 88,95% CI（8.01, 17.75 ）, P 〈 0. 00001 ] and Hct [ WMD = 3.75,95% CI （2. 36,5.13 ）, P 〈0. 00001 ]. Safety： there were significant differences between levocarnitine combined with rHuEPO and rHuEPO alone in the incidence of hypertension [ RR = 0. 34,95% CI （ 0.20,0. 59 ） ]. Conclusion The current evidence shows that levocarnitine significantly benefits hemodialy- sis -related renal anemia.