左卡尼汀联合促红细胞生成素对尿毒症肾性贫血及左室重构的影响

Effect of Levocarnitine Combined with Erythropoietin on Renal Anemia and Left Ventricular Remodeling in Patients with Uremia

目的探讨左卡尼汀联合促红细胞生成素对尿毒症肾性贫血及左室重构的影响。方法将医院2014年1月至2017年3月收治的102例尿毒症患者随机分为观察组(52例)和对照组(50例),两组患者均规律皮下注射100～150 U/kg重组人促红素注射液,3次/周。观察组患者在此基础上每次透析后加用左卡尼汀注射液1 g,静脉注射。两组患者均连续治疗6个月。结果观察组患者的贫血治疗总有效率为96.15%,明显高于对照组的78.00%(χ~2=6.010,P<0.01);治疗后,两组患者的血红蛋白(Hb)、红细胞比容(HCT)、血清铁蛋白(SF)水平均明显高于治疗前(P<0.05),左心房直径(LAD)、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)水平均明显低于治疗前(P<0.05),且观察组上述指标均优于对照组(P<0.05);观察组中舒张压升高≥10 mm Hg的患者例数明显少于对照组(χ~2=7.650,P<0.01)。结论左卡尼汀联合促红细胞生成素能有效改善尿毒症肾性贫血状态,改善左心室结构,恢复左心室功能,且安全性较高,值得推广。

Objective To investigate the clinical effect of levocarnitine combined with erythropoietin on renal anemia and left ventricular remodeling in patients with uremia. Methods Totally 102 patients with uremia admitted to our hospital from January 2014 to March2017 were randomly divided into the observation group（ 52 cases） and the control group（ 50 cases）. The two groups were given regular subcutaneous injection of 100-150 U/kg Recombinant Human Erythropoietin Injection,3 times/week,on this basis,the patients in the observation group were given intravenous injection of 1 g levocarnitine after each dialysis. The two groups were continuously treated for6 months. Results The total effective rate of anemia treatment in the observation group was 96. 15%, which was significantly higher than 78. 00% of the control group（ χ~2= 6. 010, P 〈 0. 01）. After treatment, the levels of Hb, Hct and SF in the two groups were significantly higher than those before treatment（ P 〈 0. 05）,while the levels of LAD,LVESd and LVEDd in the two groups were significantly lower than those before treatment（ P 〈 0. 05）,and the above indexes in the observation group were significantly better than those in the control group（ P 〈 0. 05）. The number of patients with DBP≥10 mm Hg in the observation group was significantly fewer than that in the control group（ χ~2= 7. 650, P 〈 0. 01）. Conclusion Levocarnitine combined with erythropoietin can effectively improve renal anemia of patients with uremic,improve the left ventricular structure,recovery the left ventricular function,and it has high safety,which is worthy of clinical promotion.