重组人促红素联合左卡尼汀在尿毒症肾性贫血维持性血液透析中的应用效果

Application of Recombinant Human Erythropoietin Combined with Levocarnitine in Maintenance Hemodialysis Patients with Uremic Renal Anemia

目的探讨重组人促红素(rhEPO)联合左卡尼汀在尿毒症肾性贫血维持性血液透析(MHD)中的应用效果。方法选取2019年1月至2020年1月平煤神马医疗集团总医院收治的尿毒症肾性贫血MHD患者84例,按随机数字表法分为2组:对照组41例予以rhEPO治疗,研究组43例予以rhEPO联合左卡尼汀治疗。比较2组治疗前后肾性贫血指标[血细胞比容(Hct)、血红蛋白(Hb)、血清白蛋白(ALB)]、左室重构指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、rhEPO用量[首次、治疗后1个月、2个月、3个月]及不良反应发生率。结果与治疗前比较,2组治疗后Hb、Hct与血清ALB水平显著升高,LVEDD、LVESD水平显著降低,且研究组各指标变化更为明显,差异有统计学意义(均P<0.05);与同组首次比较,2组不同治疗时间点(治疗后1、2、3个月)rhEPO用量均显著减少,且研究组同时间点rhEPO用量减少更为显著,差异有统计学意义(均P<0.05);与对照组比较,研究组不良反应发生率显著降低,差异有统计学意义(P<0.05)。结论rhEPO联合左卡尼汀治疗尿毒症肾性贫血MHD患者,可有效纠正患者肾性贫血,改善左室重构,还可减少rhEPO用量,降低不良反应发生率。

Objective To analyze the efficacy of recombinant human erythropoietin(rhEPO)combined with levocarnitine in maintenance hemodialysis(MHD)patients with uremic renal anemia.Methods Eighty-four MHD patients with uremic renal anemia admitted to the General Hospital of Pingmei Shenma Group from January 2019 to January 2020 were randomly treated with rhEPO alone(control group,41 patients)or in combination with levocarnitine(study group,43 patients).Renal anemia indexes(hematocrit(Hct),hemoglobin(Hb)and serum albumin(ALB)),left ventricular remodeling indexes(left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)),rhEPO dosages for initial treatment and 1,2 and 3 months after treatment,and incidence of adverse reactions were compared between the two groups.ResultsAfter treatment,the Hb,Hct and serum ALB levels increased but the LVEDD and LVESD decreased in both groups,and the changes in the study group were more obvious than those in the control groups(P<0.05).The rhEPO dosages at 1,2 and 3 months after treatment were lower than those for initial treatment in both groups(P<0.05).Furthermore,the dosages of rhEPO and incidence of adverse reactions in the study group were lower than those in the control group(P<0.05).Conclusion The combined treatment with rhEPO and levocarnitine can effectively correct renal anemia,improve left ventricular remodeling,and reduce rhEPO dosage and adverse reactions in MHD patients with uremic renal anemia.