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目的观察左卡尼汀(LC)联合促红细胞生成素(EPO)治疗维持性血液透析患者心肾贫血综合征(CRAS)的临床效果。方法将68例患者随机分为2组:EPO组34例,LC联合EPO组34例。EPO组仅每周血液透析后皮下注射EPO 10 000 U,LC联合EPO组每周血液透析后皮下注射EPO 10 000 U,同时每次血液透析后静脉缓慢注射LC 1.0 g。治疗3个月后比较2组患者血红蛋白(Hb)、红细胞压积(Hct)、左心室射血分数(LVEF)、左心室收缩/舒张末期内径(LVDs/d);评估患者心功能分级。结果 LC联合EPO组Hb、Hct升高较EPO组明显(P均<0.05),LVEF提高、LVDs/d缩小以及心功能改善也优于EPO组(P均<0.05)。结论 LC联合EPO治疗CRAS疗效明显优于单用EPO。
Objective To observe the clinical effect of levocarnitine (LC) combined with erythropoietin (EPO) in the treatment of renal anemia syndrome (CRAS) in maintenance hemodialysis patients. Methods 68 patients were randomly divided into two groups: EPO 34 cases, LC combined EPO 34 cases. The EPO group received only 10 000 EPO subcutaneously weekly after hemodialysis. EPO was given subcutaneously in the LC plus EPO group 10 000 U weekly after hemodialysis and LC 1.0 g was slowly injected intravenously after each hemodialysis. After 3 months of treatment, hemoglobin (Hb), hematocrit (Hct), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVDs / d) were compared between two groups. Results Compared with EPO group, the levels of Hb and Hct in LC group and EPO group were significantly higher than those in EPO group (all P <0.05). LVEF, LVDs / d reduction and heart function improvement were also better than those in EPO group (all P <0.05). Conclusion LC combined EPO treatment of CRAS was significantly better than EPO alone.