中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
10期
1561-1563,1564
,共4页
糖尿病肾病%血液透析滤过%左卡尼汀%红细胞生成素%贫血
糖尿病腎病%血液透析濾過%左卡尼汀%紅細胞生成素%貧血
당뇨병신병%혈액투석려과%좌잡니정%홍세포생성소%빈혈
Diabetic Nephropathy%Hemodiafiltration%L -carnitine%Erythropoietin%Anamia
目的:探讨左卡尼汀联合促红细胞生成素治疗糖尿病肾病维持血液透析患者对肾性贫血的治疗作用。方法选取维持血液透析的糖尿病肾病患者,共138例,应用随机数字表法将其分为观察组和对照组,每组各69例。所有患者给予常规治疗后,对照组给予静注重组人促红细胞生成素针每周120 IU /kg,分2次静脉注射给药;观察组在此基础上,于每次透析后给予左卡尼汀1 g 缓慢静脉注射。两组均治疗3个月。观察并比较两组治疗前后血红蛋白(HGB)、红细胞比容(Hct)、C 反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)的变化情况,比较两组不良反应发生率。结果治疗前两组 HGB、Hct 差异均无统计学意义(均 P >0.05);治疗1个月、2个月、3个月时,两组 HGB、Hct 均明显升高(均 P <0.05),但治疗1个月时两组间差异均无统计学意义(均 P >0.05),治疗2个月、3个月时观察组 HGB、Hct 水平明显高于对照组(均 P <0.01)。治疗前两组 CRP、TNF-α及 IL-6的水平差异均无统计学意义(均 P >0.05);治疗后观察组CRP、TNF-α及 IL-6均明显下降(均 P <0.01),而对照组未见明显下降(均 P >0.05)。观察组低血压、心绞痛、肌肉痉挛、心律失常不良反应发生率分别为6.8%、3.1%、14.2%、8.7%,明显低于对照组的15.9%、9.8%、18.8%、15.1%(χ2=102.158、90.672、19.654、49.782,均 P <0.01)。结论糖尿病肾病维持透析患者联合应用左卡尼汀与促红细胞生成素可有效促进血红蛋白的合成,改善机体的免疫炎症状态,改善肾性贫血,并降低不良反应发生率。
目的:探討左卡尼汀聯閤促紅細胞生成素治療糖尿病腎病維持血液透析患者對腎性貧血的治療作用。方法選取維持血液透析的糖尿病腎病患者,共138例,應用隨機數字錶法將其分為觀察組和對照組,每組各69例。所有患者給予常規治療後,對照組給予靜註重組人促紅細胞生成素針每週120 IU /kg,分2次靜脈註射給藥;觀察組在此基礎上,于每次透析後給予左卡尼汀1 g 緩慢靜脈註射。兩組均治療3箇月。觀察併比較兩組治療前後血紅蛋白(HGB)、紅細胞比容(Hct)、C 反應蛋白(CRP)、腫瘤壞死因子-α(TNF-α)及白細胞介素-6(IL-6)的變化情況,比較兩組不良反應髮生率。結果治療前兩組 HGB、Hct 差異均無統計學意義(均 P >0.05);治療1箇月、2箇月、3箇月時,兩組 HGB、Hct 均明顯升高(均 P <0.05),但治療1箇月時兩組間差異均無統計學意義(均 P >0.05),治療2箇月、3箇月時觀察組 HGB、Hct 水平明顯高于對照組(均 P <0.01)。治療前兩組 CRP、TNF-α及 IL-6的水平差異均無統計學意義(均 P >0.05);治療後觀察組CRP、TNF-α及 IL-6均明顯下降(均 P <0.01),而對照組未見明顯下降(均 P >0.05)。觀察組低血壓、心絞痛、肌肉痙攣、心律失常不良反應髮生率分彆為6.8%、3.1%、14.2%、8.7%,明顯低于對照組的15.9%、9.8%、18.8%、15.1%(χ2=102.158、90.672、19.654、49.782,均 P <0.01)。結論糖尿病腎病維持透析患者聯閤應用左卡尼汀與促紅細胞生成素可有效促進血紅蛋白的閤成,改善機體的免疫炎癥狀態,改善腎性貧血,併降低不良反應髮生率。
목적:탐토좌잡니정연합촉홍세포생성소치료당뇨병신병유지혈액투석환자대신성빈혈적치료작용。방법선취유지혈액투석적당뇨병신병환자,공138례,응용수궤수자표법장기분위관찰조화대조조,매조각69례。소유환자급여상규치료후,대조조급여정주중조인촉홍세포생성소침매주120 IU /kg,분2차정맥주사급약;관찰조재차기출상,우매차투석후급여좌잡니정1 g 완만정맥주사。량조균치료3개월。관찰병비교량조치료전후혈홍단백(HGB)、홍세포비용(Hct)、C 반응단백(CRP)、종류배사인자-α(TNF-α)급백세포개소-6(IL-6)적변화정황,비교량조불량반응발생솔。결과치료전량조 HGB、Hct 차이균무통계학의의(균 P >0.05);치료1개월、2개월、3개월시,량조 HGB、Hct 균명현승고(균 P <0.05),단치료1개월시량조간차이균무통계학의의(균 P >0.05),치료2개월、3개월시관찰조 HGB、Hct 수평명현고우대조조(균 P <0.01)。치료전량조 CRP、TNF-α급 IL-6적수평차이균무통계학의의(균 P >0.05);치료후관찰조CRP、TNF-α급 IL-6균명현하강(균 P <0.01),이대조조미견명현하강(균 P >0.05)。관찰조저혈압、심교통、기육경련、심률실상불량반응발생솔분별위6.8%、3.1%、14.2%、8.7%,명현저우대조조적15.9%、9.8%、18.8%、15.1%(χ2=102.158、90.672、19.654、49.782,균 P <0.01)。결론당뇨병신병유지투석환자연합응용좌잡니정여촉홍세포생성소가유효촉진혈홍단백적합성,개선궤체적면역염증상태,개선신성빈혈,병강저불량반응발생솔。
Objective To investigate the curative efficacy of renal anemia in patients with diabetic nephropa-thy undergoing hemodialysis treated with L -carnitine combined with erythropoietin.Methods 138 patients with dia-betic nephropathy were selected and randomly divided into two groups by the digital table,69 cases in each group. Firstly,all conditates were treated with ordinary therapies.Then,the observation group was treated with EPO 120IU /kg every week in combination with L -carnitine 1 g three times per week,while the control group was treated with the same dose of EPO only.They all treated for 3 months.Then,the levels of HGB,Hct,CRP,TNF -α,IL -6 before and after treatment were compared.Results Before treatment,there was no difference in the HGB,Hct levels between the two groups(all P >0.05).After treatment,the HGB,Hct levels of both groups all increased(all P <0.05),and the observation group increased higher in the 2nd and 3rd month(all P <0.05),although there was no difference in the 1st month(all P >0.05).Before treatment,there was no difference in the levels of CRP,TNF -α,IL -6 betwseen the two groups(all P >0.05)The levels of CRP,TNF -α,IL -6 all significantly decreased after treatments in the obser-vation group(all P <0.01 ),but there was no difference in the control group before and after treatment(all P >0.05).The hypotension,angina pectoris,muscle cramps,arrhythmia adverse reaction rate of the observation group were 6.8%,3.1%,14.2%,8.7%,which were significantly lower than 15.9%,9.8%,18.8%,15.1% of the con-trol group(χ2 =102.158,90.672,19.654,49.782,all P <0.01).Conclusion L -carnitine combined with erythro-poietin has an excellent effect on diabetic nephropathy undergoing hemodialysis.