左卡尼汀联合促红细胞生成素治疗血液透析并肾性贫血的临床疗效

Clinical effect of levocarnitine combined with erythropoietin on hemodialysis with renal anemia patients

目的探讨左卡尼汀联合促红细胞生成素(EPO)治疗血液透析并肾性贫血的临床疗效.方法选取武汉科技大学附属天佑医院2017年7月-2018年6月收治的血液透析并肾性贫血患者178例,采用随机数字表法分为对照组和观察组,各89例.对照组患者给予重组人EPO,观察组患者对照组基础上给予左卡尼汀治疗.两组患者连续治疗12周.比较两组患者治疗前,治疗后1、3个月贫血指标,包括红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、网织红细胞百分比(RET%);红细胞代谢能力指标,包括红细胞长、短轴计算比值(L/W)、红细胞内钙浓度(Ca2+),并观察两组患者不良反应发生情况.结果治疗前两组患者RBC、Hb、HCT、RET%、L/W、Ca2+比较,差异无统计学意义(P>0.05);治疗后1、3个月观察组患者RBC、Hb、HCT、L/W高于对照组,RET%、Ca2+低于对照组(P<0.05).两组患者不良反应发生率比较,差异无统计学意义(P>0.05).结论左卡尼汀联合EPO能有效延长血液透析并肾性贫血患者红细胞寿命,改善其贫血状态,减缓红细胞代谢,且安全性较高.

Objective To investigate the clinical effect of levocarnitine combined with EPO on hemodialysis with renal anemia patients.Methods A total of 178 cases of patients undergoing hemodialysis with renal anemia were selected from July 2017 to June 2018 in Affiliated Tianyou Hospital of Wuhan University of Science and Technology,which were divided into control group and observation group by random number table,89 cases in each group.The control group were given recombinant human EPO,the observation group were given levocarnitine based on control group.Two groups were treated for 12 weeks.Anemia indexes including RBC,Hb,HCT,RET%;indicators of erythrocyte metabolic capacity including L/W,Ca2+ were compared between the two groups before treatment and 1 and 3 months after treatment,adverse reactions were observed.Results There was no significant differences in RBC,Hb,HCT,RET%,L/W or Ca2+ between the two groups before treatment(P>0.05);1 or 3 months after treatment,the observation group of RBC,Hb,HCT,L/W were higher than control group,while RET% and Ca2+ were lower than control group(P<0.05).There was no significant difference in incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Levocarnitine combined with EPO can effectively prolong the life span of erythrocyte in hemodialysis with renal anemia patients,improve anemia status,slow down erythrocyte metabolism,and with high safety.