长程左旋卡尼汀治疗35例维持性血液透析患者EPO低反应性贫血的效果观察

目的了解维持性血液透析患者中存在促红细胞生成素（EPO）治疗反应低下者经过长程左旋卡尼汀治疗后贫血的纠正情况。方法存在促红素低反应性贫血的患者35例，均于每次透析结束时静脉给予左旋卡尼汀1g，疗程6个月，对比治疗前后血红蛋白、血细胞比容、EPO使用剂量、血清铁、转铁蛋白饱和度、总铁结合力、血清铁蛋白及白蛋白、前白蛋白等指标。结果左旋卡尼汀治疗6个月后血红蛋白、血细胞比容、白蛋白、前白蛋白、总铁结合力水平较治疗前明显上升（P〈0.01），血清铁、转铁蛋白饱和度变化无统计学差异，6个月治疗后EPO使用剂量较前明显下降22.4％。结论左旋卡尼汀可明显改善尿毒症EPO低反应性患者的贫血状况、减少EPO的用量，同时改善此类病人的营养状况。

Effect of long term levocarnitine therapy on erythropoietin hyporesponsive anemia in 35 maintenance hemodialysis patients

Objective To demonstrate whether long time levocarnitine therapy can improve EPO - byporesponsive anemia in maintenance hemodialysis patients. Methods Thirty - five maintenance hemodialysis patients with EPO - hyporesponsive anemia were infused with 1 g of levocarnitine at the end of each hemodialysis for 6 months. Hemoglobin, hematocrit, dosage of EPO, serum ferrum, TSAT,TtBC, ferritin, serum albumin, and proalbumin were measured before and after the therapy. Results Hemoglobin, hematocrit, albumin, proalbumin, and TIBC were improved significantly after the long time therapy（ P 〈 0.01 ）. Serum ferrum and TSAT have no statistical change. The dosage of EPO reduced 22.4% than before. Conclusion Long term levocarnitine therapy may improve EPO - hyporesponsive anemia, reduce the dosage of EPO and improve nutritional state of the patients on maintenance hemodialysis.