左卡尼汀联合蔗糖铁治疗尿毒症维持性血液透析肾性贫血患者的效果

Effects of Levocarnitine combined with Iron sucrose in treatment of uremic patients with renal anemia undergoing maintenance hemodialysis

目的:观察左卡尼汀联合蔗糖铁治疗尿毒症维持性血液透析(MHD)肾性贫血患者的效果。方法:选取2021年4月至2022年10月该院收治的86例尿毒症MHD肾性贫血患者进行前瞻性研究,根据抽签法将其分为对照组和观察组各43例。对照组采用蔗糖铁治疗,观察组在对照组基础上采用左卡尼汀治疗,比较两组临床疗效、治疗前后贫血相关指标[红细胞比容(Hct)、铁蛋白(SF)、血红蛋白(Hb)、转铁蛋白饱和度(TSAT)]水平、钙磷平衡指标[血钙、全段甲状旁腺激素(iPTH)、血磷、成纤维细胞生长因子23(FGF-23)]水平、肾功能指标[尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)]水平和不良反应发生率。结果:观察组治疗总有效率为97.67%(42/43),高于对照组的81.40%(35/43),差异有统计学意义(P<0.05);治疗后,观察组Hb、TSAT、SF、Hct、血钙、Ccr水平均高于对照组,iPTH、血磷、FGF-23、Scr、BUN水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:左卡尼汀联合蔗糖铁治疗尿毒症MHD肾性贫血患者可提高治疗总有效率和贫血相关指标水平,改善钙磷平衡指标和肾功能指标水平,效果优于单纯蔗糖铁治疗。

Objective:To observe effects of Levocarnitine combined with Iron sucrose in treatment of uremic patients with renal anemia undergoing maintenance hemodialysis(MHD).Methods:A prospective study was conducted on 86 uremic patients with renal anemia undergoing MHD admitted to the hospital from April 2021 to October 2022.According to the lottery method,they were divided into control group and observation group,43 cases in each group.The control group was treated with Iron sucrose,while the observation group was treated with Levocarnitine on the basis of that of the control group.The clinical efficacy,the anemia-related indicator levels[hematocrit(Hct),ferritin(SF),hemoglobin(Hb),transferrin saturation(TSAT)]before and after the treatment,the calcium and phosphorus balance indicator levels[blood calcium,intact parathyroid hormone(iPTH),blood phosphorus,fibroblast growth factor 23(FGF-23)],the renal function indicator levels[urea nitrogen(BUN),serum creatinine(Scr),endogenous creatinine clearance rate(Ccr)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 97.67%(42/43),which was higher than 81.40%(35/43)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of Hb,TSAT,SF,Hct,blood calcium and Ccr in the observation group were higher than those in the control group,and the levels of iPTH,blood phosphorus,FGF-23,Scr and BUN were lower than those in the control group,the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Levocarnitine combined with Iron sucrose in the treatment of uremic patients with renal anemia undergoing MHD can improve the total effective rate of treatment and the levels of anemia-related indicators and improve the levels of calcium and phosphorus balance indicators and renal function indicators.Moreover,it is superior to single Iron sucrose treatment.