腺苷钴胺联合左卡尼汀及血液灌流治疗尿毒症周围神经病变的效果  

Effect of Cobamamide combined with Levocarnitine and hemoperfusion in the treatment of patients with uremic peripheral neuropathy

作　　者：李刚 覃春美 赵艳 王明初[1] 袁云华[1] LI Gang;QIN Chunmei;ZHAO Yan;WANG Mingchu;YUAN Yunhua(Department of Internal Medicine,Luzhou People's Hospital,Luzhou,Sichuan 646000,China)

机构地区：[1]泸州市人民医院内科,四川泸州646000

出　　处：《医药前沿》2025年第7期16-19,共4页Journal of Frontiers of Medicine

基　　金：四川省医学(青年创新)科研课题计划(S22033);泸州市科技计划项目(2021-JYJ-80)。

摘　　要：目的 探讨腺苷钴胺联合左卡尼汀及血液灌流治疗尿毒症周围神经病变(UPN)患者的临床效果。方法 选取2016年12月—2020年12月泸州市人民医院收治的接受维持性血液透析治疗的UPN患者98例,采用随机数字表法将其分为观察组和对照组,各49例。对照组给予2次/周的血液透析及1次/周血液灌流联合血液透析治疗,并接受左卡尼汀注射液静脉注射治疗。观察组在对照组治疗基础上给予腺苷钴胺片口服治疗,比较两组患者治疗前和治疗8周后的临床症状、感觉神经传导速度及多伦多临床评分系统评分。结果 治疗8周后,观察组肢体疼痛、感觉障碍、麻木以及不宁腿综合征发生率低于对照组,正中神经和腓总神经感觉神经传导速度快于对照组,神经反射、感觉功能、神经症状评分和总分低于对照组,差异有统计学意义(P<0.05)。结论 论腺苷钴胺联合左卡尼汀及血液灌流治疗UPN患者具有良好临床效果,能够改善临床症状,加快感觉神经传导速度,促进神经功能恢复,从而提高患者生活质量。Objective To investigate the clinical effect of Cobamamide combined with Levocarnitine and hemoperfusion in the treatment of patients with uremic peripheral neuropathy(UPN).Methods A total of 98 UPN patients who underwent maintenance hemodialysis in Luzhou People's Hospital from December 2016 to December 2020 were selected and divided into observation group and control group by random number table method,with 49 cases in each group.The control group was given hemodialysis by twice per week and hemoperfusion by once per week combined with hemodialysis,and intravenous injection of Levocarnitine Injection was also given.The observation group was given oral administration of Cobamamide Tablets on the basis of treatment for the control group.The clinical symptoms,sensory nerve conduction velocity and Toronto Clinical Scoring System scores were compared between the two groups before and after 8 weeks of treatment.Results After 8 weeks of treatment,in the observation group,the incidence rates of limb pain,sensory disturbance,numbness and restless leg syndrome were lower than those in the control group,while the sensory nerve conduction velocities of median nerve and common peroneal nerve were faster than those in the control group,and the scores and total scores of nerve reflex,sensory function and neurological symptoms were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Cobamamide combined with Levocarnitine and hemoperfusion has a good clinical effect in the treatment of UPN patients.It can improve clinical symptoms,accelerate sensory nerve conduction velocity,and promote the recovery of neurological function in order to improve the quality of life of patients.

关 键 词：尿毒症 周围神经病变 腺苷钴胺 左卡尼汀 血液灌流 血液透析 多伦多临床系统 

分 类 号：R651[医药卫生—外科学]