左卡尼汀辅助治疗透析前慢性肾衰竭患者贫血的疗效观察
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[摘要] 目的：观察左卡尼汀辅助治疗慢性肾衰竭非透析患者肾性贫血的疗效和安全性。方法：采用随机对照研究，将我院2010年1～10月入院的慢性肾衰竭未透析患者62例随机分为两组。治疗组左卡尼汀辅助常规剂量重组人促红细胞生成素(EPO)治疗31例，对照组单用常规剂量重组人促红细胞生成素治疗31例。观察两组方法治疗4周及8周后贫血指标及血压等副反应的变化。结果：治疗组治疗后第4周血红蛋白及血细胞比容水平明显高于对照组，治疗第8周EPO用量明显减少，血压升高发生率比对照组亦有减少。结论：左卡尼汀可以明显提高EPO对透析前慢性肾衰竭患者贫血的疗效，且EPO用量减少，安全有效。
[关键词] 左卡尼汀；肾性贫血；非透析治疗
[中图分类号] R692.5[文献标识码]A[文章编号]1673-7210(2011)03(c)-068-03
Effects of L-carnitine combined with erythropoietin on renal anemia in patients with predialysis chronic renal failure
CHEN Min, HUI Yan, LU Ruiting
Department of Nephrology, Shuangshan Hospital of Anshan city, Liaoning Province, Anshan 114032, China
[Abstract] Objective: To observe the effects of L-carnitine combined with erythropoietin (EPO) on treating patients with non-dialysis and assess whether combined therapy could increase the level of the Hb and Hct and decrease the requirement for exogenous erythropoietin and safety. Methods: sixty-two patients were randomly divided into two groups, 31 patients in treatment group were treated with regular dose EPO and L-carnitine. 31 patients in control group were treated with regular dose EPO, the strategy was carried on for 8 weeks. Then the results of anemia and the risk of hypertension were compared in two groups. Results: The improvement of blood morphology parameters (Hb and Hct) were observed in each group after 4 weeks and 8 weeks, significant improvement appeared in treatment group than in control group (P<0.01), and less EPO was used in the treatment group, elevation incidence of blood pressure of treatment group decreased than that of control group. Conclusion: L-carnition combined with erythropoietin can significantly improve nephritic anemia in non-dialysis patients, and make patients more safety and useful.
[Key words] L-carnitine; Nephritic anemia; Non-dialysis therapy
肾性贫血是慢性肾衰竭(chronic renal failure，CRF)患者最常见的临床表现之一，导致其原因主要是重组人促红细胞生成素(erythropoietin，EPO)的绝对或相对缺乏，因此患者普遍需要EPO的治疗；然而临床上存在一部分患者在给予铁剂等充足的造血原料及EPO治疗后仍不能有效纠正贫血。近几年医学研究者认为可能与左卡尼汀缺乏有关，并在维持性透析患者中做了一些相关实验，取得了满意的疗效[1-2]。笔者就透析前慢性肾衰竭患者使用左卡尼汀纠正贫血的疗效、安全性方面做一调查，现报道如下：
1 对象与方法 ......
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