左卡尼汀联合人促红细胞生成素治疗维持性血液透析肾性贫血患者的效果

Effects of L-carnitine combined with human erythropoietin in treatment of maintenance hemodialysis patients with renal anemia

目的:观察左卡尼汀联合人促红细胞生成素治疗维持性血液透析肾性贫血患者的效果。方法:选取2021年1月至2023年5月该院收治的80例维持性血液透析肾性贫血患者进行前瞻性研究,根据随机数字表法将其分为对照组和观察组各40例。对照组给予人促红细胞生成素治疗,观察组在对照组基础上联合左卡尼汀治疗。比较两组临床疗效、治疗前后贫血指标[血红蛋白(Hb)、前白蛋白(PA)、血钙、血磷]水平、肾功能指标[血肌酐(Scr)、β2微球蛋白(β2-MG)、转化生长因子-β1(TGF-β1)、胱抑素C(Cys-C)]水平和不良反应发生率。结果:观察组治疗总有效率为97.50%(39/40),高于对照组的80.00%(32/40),差异有统计学意义(P<0.05);治疗后,两组Hb、PA、血钙水平均高于治疗前,且观察组高于对照组,两组血磷水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组Scr、β2-MG、TGF-β1、Cys-C水平均低于治疗前,且观察组低于对照组,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:左卡尼汀联合人促红细胞生成素治疗维持性血液透析肾性贫血患者可提高治疗总有效率,改善贫血指标水平,降低肾功能指标水平,其效果优于单纯人促红细胞生成素治疗。

Objective:To observe effects of L-carnitine combined with human erythropoietin in the treatment of maintenance hemodialysis patients with renal anemia.Methods:A prospective study was conducted on 80 patients with maintenance hemodialysis and renal anemia admitted to this hospital from January 2021 to May 2023.According to the random number table method,they were divided into control group and observation group,40 cases in each group.The control group was treated with human erythropoietin,while the observation group was treated with levocarnitine on the basis of that of the control group.The clinical efficacy,the levels of anemia indexes[hemoglobin(Hb),prealbumin(PA),serum calcium,serum phosphorus],the levels of renal function indexes[serum creatinine(Scr),β2-microglobulin(β2-MG),transforming growth factor-β1(TGF-β1),cystatin C(Cys-C)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 97.50%(39/40),which was higher than 80.00%(32/40)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of Hb,PA and serum calcium in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the blood phosphorus levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).The levels of Scr,β2-MG,TGF-β1 and Cys-C in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and 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:L-carnitine combined with human erythropoietin in the treatment of the maintenance hemodialysis patients with renal anemia can improve the total effective rate of treatment,improve the levels of anemia indexes,and reduce the levels of renal function indexes.Moreover,it is superior to single human erythropoietin treatment.