左卡尼汀联合红细胞生成素治疗心肾贫血综合征被引量：1

Effects of L-carnitine with erythropoentin on cardio-renal anemia syndrome

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摘要目的评价左卡尼汀（LC）联合红细胞生成素（EPO）治疗维持性血液透析心肾贫血综合征（CRAS）患者的临床效果。方法将91例维持性血液透析患者分为LC联合EPO组（A组）35例、EPO组（B组）30例和对照组26例。各组按常规剂量服用琥珀酸亚铁、叶酸和肌肉注射维生素B12。A组于血液透析后以1．0gLC加入20ml生理盐水缓慢静脉注射，同时皮下注射EPO3000 U／次，每周2次。B组仅于每次血液透析后皮下注射EPO3000U／次。结果治疗后，A组血红蛋白（Hb）由（72．36±10．24）g／L升高至（105．35±12．32）g／L（P〈0．01）；治疗前按纽约心脏病协会（NYHA）心功能分级，Ⅲ级16例，Ⅳ级19例；治疗后心功能Ⅱ级16例，Ⅲ级17例，Ⅳ级2例。治疗后，B组Hb由（70．21±11．42）g／L升高至（80．48±3．24）g／L（P〈0．05）；治疗前心功能Ⅲ级14例，Ⅳ级16例，治疗后Ⅱ级5例，Ⅲ级15例，Ⅳ级10例。对照组治疗前、后Hb及心功能无明显变化。A组与B组比较，前者Hb升高明显高于后者，且前者心功能改善亦优于后者。结论LC联合EPO治疗CRAS的临床效果明显优于单用EPO。 Objective To evaluate the effects of Dcarnitine （LC） with erythropoentin （EPO） on anemia and cardiac function in patients with cardio-renal anemia syndrome （CRAg） who received maintenance hemodialysis. Methods The 91 patients subject to maintenance hernodialysis with CRAS were divided into three gmups：LC＋ EPO group （group A）, n = 35, receiving L-camitine （1.0 g dissolved in 0. 9% sodium chloride 20 mL）, intravenous injection slowly after hemodialysis, two times every week, and erythropoentin 3 000 U, subcutaneous injection, two times every week; EPO group （group B）, n = 30, receiving EPO only as the same in group A;control group,n = 26 of 26,given neither LC nor EPO. All patients of the three groups were given succinylferrous, folic acid and vitamin BI2. Results The mean hemoglobin levels in group A were （72. 36 ± 10. 24） and （105.35 ± 12. 32） g/L,and in group B （70. 21 ±11.42） and （80. 48 ±3. 24） g/L, respectively before and 6 months after treatment （all P〈 0. 01 ）. Before and 6 months after treatment, there were 16 cases of NYHA Ⅲ degree and 19 cases of Ⅳ degree,and 16 cases of Ⅱ degree, 17 cases of Ⅲdegree and 2 cases of Ⅳ degree in group A; 14 cases of Ⅲ degree and 16 cases of Ⅳ degree, and 5 cases of Ⅱ degree, 15 cases of Ⅲ degree and 10 cases of Ⅳ degree in group B, respectively. The cardiac function in group A was more significantly improved than in group B. In control group there was no significant change in Hb and cardiac function. Conclusions The effectiveness of LC with EPO for CRAS was superior to that of EPO along .

作者张鹏鹏

机构地区江苏省南通市通州区人民医院肾内科

出处《临床肾脏病杂志》 2011年第1期23-25,共3页 Journal Of Clinical Nephrology

关键词肾衰竭慢性肾透析贫血心力衰竭充血性 Renal failure,chronic Renal dialysis Anemia Heart failure,congestive

分类号 R556.905 [医药卫生—血液循环系统疾病]

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