左卡尼汀联合甲钴胺治疗尿毒症周围神经病变患者的临床研究  

Clinical trial of levocarnitine combined with mecobalamine in the treatment of patients with uremic peripheral neuropathy

作　　者：宛家奎[1] 章凌云[1] 汪宏[2] 李金玉[1] WAN Jia-kui;ZHANG Ling-yun;WANG Hong;LI Jin-yu(Department of Blood Purification,Huangshan People's Hospital,Huangshan 245000,Anhui Province,China;Department of Kidney Disease,Huangshan People's Hospital,Huangshan 245000,Anhui Province,China)

机构地区：[1]黄山市人民医院血液净化科,安徽黄山245000 [2]黄山市人民医院肾脏病科,安徽黄山245000

出　　处：《中国临床药理学杂志》2024年第24期3558-3562,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察左卡尼汀注射液联合甲钴胺注射液与血液透析治疗尿毒症周围神经病变的临床疗效。方法将尿毒症周围神经病变患者按照队列法分为试验组及对照组。对照组给予甲钴胺注射液,每次0.5 g,每次透析后给药,每周3次,静脉滴注。试验组在对照组治疗的基础上给予左卡尼汀注射液,每次1 g,每次透析后给药,每周3次,静脉滴注。2组患者均治疗12周。比较2组患者治疗后的临床疗效、症状改善情况、神经传导速度[感觉神经传导速度(SCV)、运动神经传导速度(MCV)]、氧化应激指标、炎症因子,并进行安全性评价。结果对照组入组35例,试验组入组45例。治疗后,试验组及对照组总有效率分别为93.33%(42例/45例)和77.14%(27例/35例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组和对照组的腓总神经SCV分别为(41.73±4.05)和(38.67±3.73)m·s^(-1),腓总神经MCV分别为(46.62±4.41)和(43.51±4.29)m·s^(-1),血清晚期氧化蛋白产物含量分别为(81.75±14.36)和(109.43±18.57)μmol·L^(-1),血清谷胱甘肽过氧物酶含量分别为(73.39±6.05)和(61.83±5.72)U·L^(-1),血清超氧化物歧化酶含量分别为(90.68±11.28)和(79.95±9.03)U·L^(-1),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有皮疹、食欲缺乏、头晕;对照组的药物不良反应主要有食欲缺乏、腹泻、呕吐。试验组和对照组的药物不良反应总发生率分别为11.11%(5例/45例)和8.57%(3例/35例),在统计学上差异无统计学意义(P>0.05)。结论左卡尼汀注射液联合甲钴胺注射液与血液透析治疗尿毒症周围神经病变的疗效确切,能减轻患者临床症状,促进神经传导速度恢复。Objective To observe the clinical curative effect of levocarnitine injection combined with mecobalamine injection and hemodialysis in uremic peripheral neuropathy.Methods The patients with uremic peripheral neuropathy were divided into treatment group and control group according to cohort method.The patients in the control group was given mecobalamine injection,0.5 g each time,after each dialysis,3 times a week,intravenous drip.On the basis of the treatment of the control group,the treatment group was given levocarnitine injection,1 g each time,after each dialysis,3 times a week,intravenous drip.Both groups were treated for 12 weeks.Results There were35 cases in control group and 45 cases in treatment group.After treatment,total response rates of treatment group and control group were 93.33%(42 cases/45 cases)and 77.14%(27 cases/35 cases),the difference was statistically significant(P<0.05).After treatment,sensory nerve conduction velocity(SCV)of common peroneal nerve in treatment group and control group were(41.73±4.05)and(38.67±3.73)m·s^(-1);MCV of common peroneal nerve were(46.62±4.41)and(43.51±4.29)m·s^(-1);levels of serum advanced oxidized protein product were(81.75±14.36)and(109.43±18.57)μmol·L^(-1);levels of glutathione peroxidase were(73.39±6.05)and(61.83±5.72)U·L^(-1);levels of superoxide dimutase were(90.68±11.28)and(79.95±9.03)U·L^(-1),differences were statistically significant(all P<0.05).The adverse drug reactions in treatment group were mainly on rash,loss of appetite and dizziness,while which in control group were mainly on loss of appetite,diarrhea and vomiting.There were no significant difference in total incidence of adverse drug reactions between treatment group and control group[11.11%(5 cases/45 cases)vs 8.57%(3 cases/35 cases)].Conclusion Curative effect of levocarnitine injection combined with mecobalamine injection and hemedialysis is significant in patients with uremic peripheral neuropathy,which can relieve clinical symptoms and promote the recovery of nerve conduction ve

关 键 词：左卡尼汀注射液 甲钴胺注射液 尿毒症周围神经病变 临床疗效 神经传导速度 氧化应激反应 

分 类 号：R97[医药卫生—药品]