RESULTS The free carnitine level，hemoglobin and hematocrit were significantly increased in the treatment group as compared to the control．The morbidity of EPO-related hypertension was lower in the treatment group than in the control group（10％ vs 35％，P＜0.05）．The weekly dose of r-HuEPO after 12 weeks' treatment was reduced by 50％，while no decrement of EPO could be made in the control group．
CONCLUSION The results indicated that there was a potentiating effects of L-carnitine on r-HuEPO treatment．L-carnitine was effective in improving anemia，and reducing r-HuEPO reqirement and related morbidity in EPO tereated uremic patients．
Key words r-HuEPO L-carnitine uremia
尿毒症贫血是由多种病因所致，其中包括红细胞生成素（EPO）分泌减少及红细胞寿命缩短［1］。r-HuEPO能有效地治疗尿毒症贫血。肉碱缺乏是尿毒症贫血的另一重要因素［2］。国外文献报道左旋肉碱能提高r-HuEPO的疗效，减少r-HuEPO的用量。因此，我们在临床联合应用左旋肉碱和r-HuEPO治疗尿毒症贫血患者，旨在观察左旋肉碱对r-HuEPO疗效的影响。
1 对象和方法
1.1 研究对象 尿毒症患者40例，原发病为慢性肾小球肾炎33例，慢性肾盂肾炎、原发性高血压各2例，肾结核、糖尿病及系统性红斑狼疮各1例。其入选标准：血透3个月以上，Hct≤25%；无铁、叶酸及VitB12缺乏；无顽固性高血压；无严重的继发性甲状旁腺机能亢进；停止输血1月以上；未应用血管紧张素转换酶抑制剂。剔除了失血、溶血、感染等影响因素。
1.2 分组 将患者随机分为治疗组20例，年龄为41.4±18.5岁，血透7.7±4.2个月，每周2～3次，每次4～5h。对照组20例，年龄为39.7±19.0岁，血透7.1±4.6个月，每周2～3次，每次4～5h。两组患者在年龄、性别、透析时间、透析剂量及血红蛋白(Hb)、血球压积(Hct)、血肌酐浓度等方面无显著差异。
