左卡尼汀对血液透析患者肾性贫血和左心功能的影响  

Effects of levocarnitine on nephrotic anemia and left heart function in patients under hemodialysis

作　　者：田军[1] 刘楠梅[1] 高晶[1] 胡大勇[1] 胡伟锋[1] 张金元[1] 

机构地区：[1]解放军第四五五医院肾脏科南京军区肾脏专科中心,上海200052

出　　处：《临床肾脏病杂志》2009年第10期263-265,共3页Journal Of Clinical Nephrology

摘　　要：目的观察左卡尼汀联合人重组促红细胞生成素（〉HuEPO）对维持性血液透析（MHD）患者肾性贫血、左心功能的影响。方法将78例MHD患者随机分为对照组和治疗组，每组39例。治疗组于每次血液透析结束时静脉注射左卡尼汀1.0g；对照组每次血液透析结束时静脉注射生理盐水5ml。疗程均为6个月。2组同时于血液透析后皮下注射r-HuEPO（每周75-150U／kg）。观察2组治疗前后的临床症状、体征相关的实验室检查以及超声心动图的变化。结果治疗组治疗后3个月患者血红蛋白（Hb）、红细胞压积（Hct）、血清白蛋白（Alb）、前白蛋白（PA）水平显著高于治疗前及同期对照组（P〈0.01），〉HuEPO用量减少，且患者精神状态、体力、食欲、恶心、呕吐、透析耐受性、透析中肌痉挛、心律失常或低血压等症状明显改善，治疗后6个月患者左心功能较治疗前及同期对照组明显改善（P〈0.01）。结论左卡尼汀联合r-HuEPO可以明显改善尿毒症血液透析患者肾陛贫血和左心功能。Objective To observe the effects of levocarnitine on nephrotic anemia and left heart function in patients under hemodialysis. Methods Seventy-eight hemodialysis patients were randomly divided into treatment group and control group. The patients in the treatment group received intravenous injection of levocarnitine（1g at the end of each hemodialysis for 6 months）. Both groups accepted injection of recombinant human erythropoietin （rHuEPO） after hemodialysis（75-150 U/kg per week）. The clinical symptoms, signs, related laboratory indexes and changes of ultrasonic cardiogram in both groups were observed. Results After treatment with levocarnitine for 3 months, the patients＇ mental state,physical strength, appetite, nausea, vomit, hemodialysis tolerance, muscular spasm, arhythmia, hypotension were improved significantly,doses of rHuEPO were decreased, and the levels of hemoglo- bin,hematocrit,albumin, prealbumin in the treatment group were significantly increased as compared with those before treatment and the control group（P〈0.01）. After treatment for 6 months, the left heart function was also improved significantly as compared with that before treatment and the control group （P〈0.01）. Conclusion Levocarnitine together with erythropoietin can significantly improve nephritic anemia and left heart function in patients under hemodialysis.

关 键 词：红细胞生成素 重组 贫血 肾透析 

分 类 号：R459.5[医药卫生—治疗学] R654.2[医药卫生—临床医学]