左卡尼丁联合促红素治疗尿毒症血透患者的效果观察

刘雨田

[摘要] 目的 觀察左卡尼丁联合促红素治疗尿毒症血透患者的临床效果。 方法 入选2015年4月～2017年4月的尿毒症血透肾性贫血的患者80例，随机的分成对照组与观察组，各40例。对照组在血液透析后应用促红素皮下注射治疗，观察组在透析后采用左卡尼丁联合促红素治疗。治疗后，对两组的临床疗效进行评价与比较。 结果 治疗后，在血红蛋白和红细胞压积水平方面，观察组明显高于对照组，差异有统计学的意义（P<0.05）。在不良反应发生率方面，观察组与对照组的分别为12.5%与17.5%，两组差异无统计学的意义（P>0.05）。对比两组患者治疗前的NCT-A型下降时间、血氨浓度，差异均无统计学意义；对比两组患者治疗后的NCT-A型下降时间，观察组明显少于对照组，差异有统计学意义（P<0.05）；对比两组患者治疗后的血氨浓度，观察组明显低于对照组，差异有统计学意义（P<0.05）。 结论 左卡尼丁联合促红素治疗尿毒症血透病人的肾性贫血的临床效果显著，值得在临床中推广应用。

[关键词] 左卡尼丁；促红素；尿毒症；血液透析；肾性贫血

[中图分类号] R692.5 [文献标识码] A [文章编号] 2095-0616（2017）20-57-03

Effect of the L-carnitine combined with erythropoietin for the treatment of uremia patients with hemodialysis

LIU Yutian

Department of Forth Internal Medicine， Pengpai Memorial Hospital in Haifeng County， Haifeng 516400， China

[Abstract] Objective To observe the effect of the L-carnitine combined with erythropoietin for the treatment of uremia patients with hemodialysis. Methods From April 2015 to April 2017，80 cases of renal anemia in patients with uremia and hemodialysis were chosen，and were randomly divided into control group and observation group，40 cases in each group.After hemodialysis，the patients of control group were given subcutaneous injection of erysiderin，and patients of the observation group were treated with the combination of L-carnitine combined with erythropoietin.After treatment，the clinical efficacy of two groups were evaluated and compared. Results After treatment，the level of hemoglobin and red blood cells deposited of observation group was significantly higher than those of control group，the difference was statistically significance （P<0.05）.The incidence of adverse reactions were 12.5% and 17.5% in observation group and control group respectively，the difference between the two groups had no statistical significance（P>0.05）.The decline time，blood ammonia concentration of NCT-A of two groups before treatment were compared，there were no statistically significant difference，the decline time of NCT–A of the observation group was significantly less than that of control group，and the difference was statistically significant（P<0.05），the blood ammonia concentration of NCT–A of the observation group was significantly lower than that of control group，and the difference was statistically significant （P<0.05）. Conclusion The clinical effect of L-carnitine combined with erythropoietin on the treatment of renal anemia in patients with uremia has remarkable clinical effect and it is worth promoting the application in clinic.endprint

[Key words] L-carnitine；Erythropoietin；Uremia；Hemodialysis；Renal anemia

尿毒症是严重的肾性疾病，在治疗中以血液透析为主，患者需要持续的进行血液透析治疗，在透析治疗中常见的并发症为肾性贫血，主要的病因是肾脏产生的促红细胞生素不足或者是尿毒症中的毒性物质影响红细胞的生成与代谢而造成贫血[1]。患者出现贫血后严重时会诱发肺水肿，心力衰竭等危及患者生命的疾病，因此，针对尿毒症透析的患者需要进行肾性贫血的治疗，常用的治疗方法为透析后注射促红素，但是效果并不显著[2]。本研究在治疗尿毒症血透患者中采用左卡尼丁联合促红素的治疗方式的效果较好。现报道如下。

1 资料与方法

1.1 一般资料

选择我院于2015年4月～2017年4月期间的尿毒症血透肾性贫血的患者80例，选入的患者均有尿毒症病史，需要血液透析治疗，患者表现为恶心呕吐，面色发白，乏力等症状，经实验室检查等诊断为尿毒症血透并发的肾性贫血。……