左卡尼汀联合重组人红细胞生成素对高通量血液透析尿毒症合并肾性贫血患者的影响  

Influence of levocarnitine combined with recombinant human erythropoietin in patients with uremia and renal anemia undergoing high-flux hemodialysis

作　　者：钱俊 姚迪 王萍[2] 杨娟 陶运生 QIAN Jun;YAO Di;WANG Ping;YANG Juan;TAO Yunsheng(Department of Nephrology,Tongling Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine,Tongling 244000,China;Hemodialysis Room,Tongling Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine,Tongling 244000,China;Department of Liver and Spleen and Stomach Diseases,Tongling Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Traditional Chinese Medicine,Tongling 244000,China)

机构地区：[1]安徽中医药大学附属铜陵中医医院肾内科,铜陵244000 [2]安徽中医药大学附属铜陵中医医院血透室,铜陵244000 [3]安徽中医药大学附属铜陵中医医院肝病脾胃病科,铜陵244000

出　　处：《西北药学杂志》2023年第4期193-197,共5页Northwest Pharmaceutical Journal

基　　金：铜陵市科技计划项目(编号:2013NS09)。

摘　　要：目的探究左卡尼汀联合重组人红细胞生成素(recombinant human erythropoietin,rhEPO)对高通量血液透析(high-flux hemodialysis,HFHD)尿毒症合并肾性贫血患者肾功能、心功能及营养状态的影响。方法选取88例尿毒症合并肾性贫血患者作为研究对象,用随机数字表法分为对照组和联合组,各44例,2组患者均接受HFHD治疗,对照组患者采用rhEPO治疗,联合组加用左卡尼汀治疗,疗程均为6个月。比较治疗前及治疗后2组患者的肾功能指标[血尿素氮(blood urea nitrogen,UREA)、血肌酐(serum creatinine,Scr)]、心功能指标[左心室收缩期末内径(left ventricular end-systolic diameter,LVESD)、左心室舒张期末内径(left ventricular end-diastolic diameter,LVEDD)和左心室摄血分数(left ventricular ejection fraction,LVEF)]、炎症免疫指标[超敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、降钙素原(procalcitonin,PCT)、补体C3和C4]和营养状态指标[白蛋白(albumin,ALB)、血红蛋白(hemoglobin,HB)和血清总蛋白(serum total protein,TP)]的变化。比较治疗期间2组不良反应总发生率。结果治疗后,2组UREA、Scr均低于治疗前,且联合组均低于对照组(P<0.05);2组LVESD、LVEDD均低于治疗前,且联合组均低于对照组;2组LVEF高于治疗前,且联合组高于对照组(P<0.05);2组hs-CRP、PCT均低于治疗前,且联合组低于对照组;2组C3、C4均高于治疗前,且联合组高于对照组(P<0.05);2组ALB、HB和TP均高于治疗前,且联合组均高于对照组(P<0.05);联合组不良反应总发生率为11.36%,对照组不良反应总发生率为4.55%,2组比较差异无统计学意义(P>0.05)。结论左卡尼汀联合rhEPO治疗HFHD尿毒症合并肾性贫血患者的疗效显著,可有效改善患者的肾功能、心功能和营养状态。Objective To explore the effects of the combination of levocarnitine and recombinant human erythropoietin(rhEPO)on renal function,cardiac function and nutritional status in patients with uremia and renal anemia undergoing high flux hemodialysis(HFHD).Methods 88 patients with uremia and renal anemia who received treatment in the hospital were selected as the research subjects,and were divided into control group(n=44)and combination group(n=44)according to the random number table method.The both groups received HFHD treatment,and the patients in control group were treated with rhEPO for renal anemia,while the patients in combination group were additionally given levocarnitine.The both groups were treated for 6 months.The renal function indicators[blood urea nitrogen(UREA),serum creatinine(Scr)],cardiac function indicators[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)],inflammatory immune indicators[high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),complements C3 and C4],and nutritional status indicators[albumin(ALB),hemoglobin(HB)and serum total protein(TP)]were compared between the 2 groups before and after treatment.The total incidence rate of adverse reactions during treatment was compared between the 2 groups.Results After treatment,the levels of UREA and Scr of the 2 groups were lower than those before treatment,and the levels of combination group were lower than those of control group(P<0.05).After treatment,the LVESD and LVEDD in the 2 groups were lower,while the LVEF was higher compared with before treatment,and the LVESD and LVEDD in combination group were lower than those in control group,while the LVEF was higher than that in control group(P<0.05).After treatment,the hs-CRP and PCT in the 2 groups were lower,while the C3 and C4 were higher than those before treatment,and the hs-CRP and PCT in combination group were lower than those in control group,while the C3 and C4 were higher than those in control

关 键 词：左卡尼汀 重组人红细胞生成素 高通量血液透析 肾功能 营养状态 

分 类 号：R973[医药卫生—药品]