左旋卡尼汀和rhEPO对尿毒症贫血的疗效观察

目的观察左旋卡尼汀对重组人红细胞生成素(rhEPO)纠正尿毒症贫血的促进作用。方法尿毒症维持性血透患者62例,其中30例透析后皮下注射rhEPO50～150IU/kg,每周1～2次;32例透析后静脉注射左旋卡尼汀1g,每周2次,并根据患者贫血程度给于rhEPO。治疗开始时和治疗后4、8、12周,分别检测血红蛋白、红细胞压积和血浆白蛋白。结果左旋卡尼汀联合rhEPO组血红蛋白、红细胞压积和血浆白蛋白水平均显著高于单用rhEPO组(P<0.01);联合用药组rhEPO用量明显减少(P<0.01),血压升高发生率(11%)显著低于单用rhEPO组(33%)(P<0.05)。结论左旋卡尼汀能加强rhEPO纠正贫血的疗效;因用量减少,降低了rhEPO引起高血压的发生率。

Effect of L-Carnitine on Anemia in Hemodialysis Patients Treated with rhEPO

Objective To demonstrate whether L-carnitine treatment could further improve anemia in dialyzed patients under recombinant human erythropoietin (rhEPO)therapy. Methods Sixty-two maintenance hemodialysis patients were randomly divided into two groups:control group(n=30), treatment group(n=32). In the control group,rhEPO 50~150 IU/kg was subcutaneously injected once or twice a week;treatment group,L-carnitine 1.0 g was intravenously infused after dialysis twice a week together with rhEPO. The serum albumin,hemoglobin (Hb)and hematocrit (Hct)were monitored for three months. Results The Hb,Hct and albumin values in the treatment group were significantly higher than those in the control group(P<0.01);the dosage of rhEPO in the treatment group was significantly lower than that in the control group(P<0.01). The morbidity of EPO-induced hypertension was lower in the treatment group than in the control group (11% vs. 33%) (P<0.05). Conclusion L-carnitine could further improve rhEPO therapy and correct anemia in patients with chronic renal failure. The dosage of rhEPO in patients with L-carnitine given simultaneously can be largely reduced.The morbidity of rhEPO-induced hypertension is lowered down.