左卡尼汀与促红细胞生成素合用治疗尿毒症贫血患者合并心功能不全的临床观察

目的观察左卡尼汀与重组人红细胞生成素（r-Huepo）合用于尿毒症贫血患者合并心功能不全的疗效。方法将50例合并不同程度心功能不全的尿毒症贫血患者,随机分为两组,治疗组与对照组各25例。对照组采用血透后予以r-Huepo75～150u/（kg.周）皮下注射,同时口服铁剂、叶酸和vitB12,并使用一般强心药。治疗组和对照组使用相同的药物,同时每天静脉点滴左卡尼汀2.0,治疗8周。观察患者治疗前和治疗后血红蛋白、红细胞压积、血压情况。定期采用彩超测定心脏指数CI,左室射血分数（%）,心肌收缩力DI/DT,左室舒张末经（mm）LVEED,左室收缩末径（mm）LVESD,心缩力指数（HI）,每搏输出量SV（ml）,每分输出量CO（1/min）。结果治疗组治疗后血红蛋白、红细胞压积、心肌收缩力增强,心功能指数较治疗前及对照组均明显改善（P〈0.01）。治疗组比对照组的血压升高率明显降低（P〈0.05）。结论左卡尼汀与促红细胞生成素合用可显著改善尿毒症贫血患者的心功能。

Clinical Effect of L-carnitine with EPO on Patients with Uremic Anemia Complicated with Heart Dysfuction

Objective To study the effect of L-carnitine with EPO on patients with uremic anemia complicated with heart dysfunction. Methods 50 patients with uremic anemia complicated with heart dysfunction were divided into two groups：treatment group（ n ： 25） and control group （n = 25）. The patients in control group received subcutaneous injection with EPO （75-150 u/kg · week） after dialysis, and meanwhile took oral iron supplement, folic acid, vitaminB12, and use common cardiotonic agents. The treatment group and control group use the same medicine and receive intravenous drip with 2.0 L-carnitine, whose course of treatment is 8 weeks. Observe the HB, HCT and HP from patients before and after treatment. Results After treatment,HB, HCT, DI/D were enhanced, cardiac function index was significantly improved than that before treatment and that of control group （P 〈 0.01 ） , while, blood pressure upgrade was notable lower than that of control group （ P 〈 0.05）. Conclusion L-carnitine with EPO can significantly improve cardiac funcion of patients with uremic anemia.