左卡尼汀联合重组人促红细胞生长素及铁剂治疗血液透析并发症的疗效观察  

Effectiveness of levocarnitine,EPO and ferralia to treat hemodialysis complications

作　　者：杨世霞[1] 徐进[1] 李建省[1] 丁文君[1] 

机构地区：[1]甘肃省中医院肾病科,兰州730000

出　　处：《中国临床药理学杂志》2013年第4期254-256,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的评价左卡尼汀联合重组人促红细胞生长素(EPO)及铁剂治疗血液透析并发症的疗效。方法 50例维持性血液透析患者随机分为治疗组和对照组,每组25例。治疗组于透析结束前将左卡尼汀1.0 g稀释于生理盐水20 mL,缓慢静脉注射;对照组于透析结束前静脉注入生理盐水20 mL,频次及疗程同治疗组。2组EPO治疗剂量为100～150 IU.kg-1,维持剂量为50～75 IU.kg-1。2组每次透析结束前1 h透析器静脉滴注蔗糖铁注射液5 mL,滴注30 min以上。2组疗程为12周。结果患者精神状态、胸闷、心悸、乏力,肌肉痉挛和透析相关性低血压等症状,治疗组21例明显好转,3例明显减轻,1例不明显;心律失常率,治疗组治疗后较治疗前及对照组明显减少(P<0.01);对照组25例无明显变化。血检提示血红蛋白(Hb)、红细胞比容(HCT)有不同程度的上升,疗程结束后2组均有显著升高,治疗组疗效优于对照组(P<0.01)。EPO的用量,治疗组较对照组明显减少。结论左卡尼汀治疗血液透析中并发心律失常有效,能明显改善心功能,纠正肾性贫血。Objective To evaluate the effect of levocarnitine with EPO and ferralia in treating complicated renal anemia and improving cardiac function during hemodialysis. Methods Fifty sustained hemodialysis patients were randomly divided into treatment group and control group, 25 patients in each group. The patients of treatment group were given 1.0 g levocarnitine through intravenous injection for twelve weeks before the end of hemodialysis. Control group were administered with same amount of saline water. ECG was inspected with ECG monitor. Hemoglobin （ Hb）, hematocrit（ HCT）, serum ferritsn（SF） and transferrin saturation （TSAT） were tested monthly. Results The symptom of mental condi tion, chest distress, palpitation, lassitude and muscular spasm and relat ed hypotension caused by hemodialysis evidently disappeared and myo cardial contractility enhanced in 21 patients of treatment group, and 3 ca ses were alleviated while 1 case was ineffective. The incidence of arrhyth mia was lower than that before the treatment and control group （P 〈 0. 01 ）. There was no significant difference in control group. The values of Hb and Hct increased at different degrees, and at the end of the treat ment both groups increased evidently. Treatment group was superior to control group （ P 〈 0. 01 ）. The dosage of EPO reduced remarkably in treatment group compared with control group. Conclusion Levocarnitineis effective in the treatment of complicated arrhythmia during hemodialysis, which can improve cardiac function obvious ly and correct renal anemia.

关 键 词：左卡尼汀 促红细胞生长素 铁剂 血液透析 

分 类 号：R971.22[医药卫生—药品]