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目的:探讨左卡尼汀联合蔗糖铁对血透患者肾性贫血及氧化应激的影响。方法:抽选我院2010年3月-2013年5月行维持血透治疗的肾性贫血患者79例,采用数字表法分为对照组(39例)和观察组(40例),对照组采用促红细胞生成素(EPO)、单用蔗糖铁及常规对症治疗,观察组在对照组基础上联用左卡尼汀治疗。比较两组患者治疗前、治疗6个月后血红蛋白(Hb)、血细胞比容(Hct)、血浆铁蛋白(SF)、转铁蛋白饱和度(TSAT)、晚期蛋白质氧化产物(AOPP)及血丙二醛(MDA)水平,并对两组治疗开始时、治疗3、6个月时EPO使用剂量进行比较。结果:治疗6个月后,观察组患者Hb、Hct、SF、TSAT明显高于对照组(P<0.05),AOPP、MDA明显低于对照组(P<0.05);对照组从治疗开始到治疗6个月时一直维持较高的EPO使用剂量,而观察组EPO用量依次递减,至治疗6个月时EPO用量显著低于对照组(P<0.05)。结论:左卡尼汀能联合蔗糖铁治疗肾性贫血的疗效显著,能有效缓解氧化应激反应,降低EPO用量,值得临床推广。
Objective: To investigate the effects of levocarnitine and sucrose on renal anemia and oxidative stress in hemodialysis patients. Methods: A total of 79 patients with renal anemia who underwent hemodialysis were selected from March 2010 to May 2013 in our hospital. The patients were divided into control group (39 cases) and observation group (40 cases) Erythropoietin (EPO), iron sucrose alone and conventional symptomatic treatment were used. The observation group was treated with levocarnitine on the basis of the control group. The levels of Hb, Hct, SF, TSAT, AOPP, and serum C Dialdehyde (MDA) levels, and EPO doses at the start of treatment and at 3 and 6 months of treatment were compared between the two groups. Results: At 6 months after treatment, Hb, Hct, SF and TSAT in the observation group were significantly higher than those in the control group (P <0.05), AOPP and MDA were significantly lower than those in the control group (P <0.05) The dosage of EPO was maintained at 6 months while the dosage of EPO in the observation group decreased gradually. The dosage of EPO at 6 months after treatment was significantly lower than that of the control group (P <0.05). Conclusion: L-carnitine combined with sucrose iron treatment of renal anemia significant effect, can effectively alleviate the oxidative stress response, reduce the amount of EPO, worthy of clinical promotion.