左旋肉碱与促红细胞生成素并用治疗尿毒症贫血

　 来源：120online    　 日期：2007-05-04

　　摘　要　目的：观察左旋肉碱对重组人红细胞生成素（r-HuEPO）疗效的影响。　方法：将40例尿毒症血透患者随机分成两组。两组同时于血透后予以r-HuEPO100～150U／（kg·周）皮下注射。待血球压积（Hct）≥30％后减量，维持Hct在30%～35％。治疗组于每次血透后静脉推注左旋肉碱1.0g，而对照组不用。血浆游离肉碱浓度采用放射化学酶联法测定。　结果：治疗组血浆游离肉碱浓度及血红蛋白（Hb）、Hct水平显著高于对照组（P＜0.01)。而血压升高发生率显著低于对照组（10％和35％。P＜0.05）。治疗组于治疗后第12周r-HuEPO用量仅为治疗前的一半，而对照组无明显改变。　结论：左旋肉碱能显著提高r-HuEPO的疗效，纠正贫血，减少r-HuEPO用量，降低促红细胞生成素相关高血压的发生率。

THE ANTI-ANEMIC EFFECTS OF COMBINED tREATMENT WITH L-CARNITINE AND RECOMBINANT HUMAN ERYTHROPOETIN IN UREMIC pATIENTS

Wang Furong，Yuan zhihong，Xu Hongshi

　　division of Nephrology，Changzheng Hospital，The second Military University，Shanghai 200003

　　OBJECTIVE to observe the therapeutic effects of L-carnitine on anemic uremia patients who were treated with recombinant human erythropoeitin（r-HuEPO）．

　　METHODOLOGY Forty patients with renal anemia were included and randomly divided into treatment group and control group．Inclusion criteria were maintenance hemodialysis for at least three months，hematocrit less than 25％，without uncontrolled hypertension or secondary parathyroidism，without severe deficiency of iron or folic acid or vitamins．All patients received r-HuEPO（100-150 U／kg·w）after each session of hemodialysis，and iron，folic acid vitamin B12．With hemaocrit values becoming greater than 30％，the weekly r-HuEPO dose was reduced in order to maintain HCT between 30%-50％．For the treatment group，L-carnitine（1 g intraveneously after each session of hemodialysis）was administered for 12 weeks．Plasma levels of L-carnitine were measured by radioenzymatic assay．

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