左卡尼汀辅助治疗对维持性血液透析贫血及脏器功能损伤的影响

Effect of adjuvant Levocarnitine therapy on anemia and organ dysfunc-tion in patients with maintenance hemodialysis

目的分析左卡尼汀辅助治疗对维持性血液透析患者贫血及脏器功能损伤的影响。方法收集2013年12月~2015年12月海军总医院收治的尿毒症患者90例,按照随机数表法将其分为观察组和对照组,各45例。对照组接受常规治疗,观察组在常规治疗的基础上接受左卡尼汀辅助治疗。治疗后3个月,采用全自动生化仪测定血清贫血相关指标、残余肾功能;采用彩色多普勒超声仪测定心功能指标;采用肌电图仪测定周围神经病变指标。结果观察组治疗后血清血红蛋白、白蛋白、前白蛋白、铁蛋白含量及血细胞比容水平均显著高于对照组(P<0.05),血清血肌酐、尿素氮、胱抑素C及微量元素钾、血磷、钙含量均显著低于对照组(P<0.05),超声下每搏量、心输出量水平均显著高于对照组,左心室收缩末期内径、左心室舒张末期内径水平及舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值均显著低于对照组(P<0.05),正中神经、胫神经、腓总神经的感觉神经传导速度、运动神经传导速度水平均显著高于对照组(P<0.05)。结论左卡尼汀辅助治疗可缓解血液透析患者的贫血严重程度,减轻脏器及周围神经功能损伤。

Objective To analyze the effect of adjuvant Levocarnitine therapy on anemia and organ dysfunction in patients with maintenance hemodialysis. Methods Ninety cases of patients with maintenance hemodialysis in Navy General Hospital from December 2013 to December 2015 were chosen as research objects, all patients were divided into observation group and control group according to random number table method, each group had forty-five cases. Con- trol group was treated with routine therapy, observation group was treated with adjuvant Levocarnitine therapy plus rou- tine therapy. Three months after treatment, the serum anemia and residual renal function related indicators of the two groups were measured by automatic biochemical analyzer; the indexes of heart function were measured by color Doppler ultrasound; the indexes of peripheral neuropathy were evacuated by eleetromyography. Results After treatment, the contents of serum hemoglobin, albumin, prealbumin and ferritin contents as well as the hematocrit levels in observation group were higher than those in control group （P 〈 0.05）, the contents of serum creatinine, blood urea nitrogen, cystatin C, kalium, phosphorus and calcium in observation group were lower than those in control group （P 〈 0.05）, the ultrasound stroke volume and cardiac output levels in observation group were higher than those in control group （P 〈 0.05）, the left ventricular systolic function, left ventricular end diastolic pressure and E/A levels in observation group were lower than those in control group （P 〈 0.05）, the sensory nerve conduction velocity and motor nerve conduction velocity levels of median nerve, tibial nerve and common peroneal nerve in observation group were higher than those in control group （P 〈 0.05）. Conclusion Adjuvant Levocarnitine therapy can alleviate the severity of anemia, and reduce the organ and peripheral nerve dysfunction in patients with hemodialysis.