CAJ | 학술논문

目的：探讨生血宁联合左卡尼汀辅助治疗肾性贫血的疗效。方法选择2012年1月至2014年1月在我科维持性血液透析患者96例,采用随机数字表法将其分为生血宁+左卡尼汀组(A组)、琥珀酸亚铁+左卡尼汀组(B组)和琥珀酸亚铁组(C 组),每组32例。各组患者均常规服用叶酸及维生素B12,皮下注射重组人促红细胞生成素(recombinant human erythropoietin,rhEPO)。在此治疗基础上,A组口服生血宁片0.5 g,3次/d,并于每次血液透析结束时给予左卡尼汀1 g 溶于20 ml生理盐水静脉推注3~5 min；B组口服琥珀酸亚铁0.2 g,3次/d,并于每次血液透析结束时给予左卡尼汀1 g 溶于20 ml 生理盐水静脉推注3~5 min；C 组口服琥珀酸亚铁0.2 g,3次/d。治疗过程中避免使用其他铁剂及影响铁代谢的药物,连续治疗3个月后观察疗效。结果各组治疗后血红蛋白(hemoglobin,Hb)、血细胞比容(hematocrit,Hct)、血清铁(serum iron,SI)、总铁结合力(total iron binding force,TIBC)、血清铁蛋白(serum ferritin,SF)、转铁蛋白饱和度(transferrin saturation, TSAT)较治疗前均明显升高,差异有统计学意义(P<0.05)；治疗后第3个月,A 组 Hb、Hct、SI、TIBC、SF、TSAT均高于B组,差异有统计学意义(P<0.05)。各组患者 EPO 用量比治疗前下降,差异有统计学意义(P<0.05)；A组治疗后 EPO 用量也明显低于 B组和 C组,差异有统计学意义(P<0.05)。结论生血宁联合左卡尼汀辅助治疗血液透析患者肾性贫血,能明显改善患者贫血状况,减少不良反应发生,并且可以减少 EPO用量。
목적：탐토생혈저연합좌잡니정보조치료신성빈혈적료효。방법선택2012년1월지2014년1월재아과유지성혈액투석환자96례,채용수궤수자표법장기분위생혈저+좌잡니정조(A조)、호박산아철+좌잡니정조(B조)화호박산아철조(C 조),매조32례。각조환자균상규복용협산급유생소B12,피하주사중조인촉홍세포생성소(recombinant human erythropoietin,rhEPO)。재차치료기출상,A조구복생혈저편0.5 g,3차/d,병우매차혈액투석결속시급여좌잡니정1 g 용우20 ml생리염수정맥추주3~5 min；B조구복호박산아철0.2 g,3차/d,병우매차혈액투석결속시급여좌잡니정1 g 용우20 ml 생리염수정맥추주3~5 min；C 조구복호박산아철0.2 g,3차/d。치료과정중피면사용기타철제급영향철대사적약물,련속치료3개월후관찰료효。결과각조치료후혈홍단백(hemoglobin,Hb)、혈세포비용(hematocrit,Hct)、혈청철(serum iron,SI)、총철결합력(total iron binding force,TIBC)、혈청철단백(serum ferritin,SF)、전철단백포화도(transferrin saturation, TSAT)교치료전균명현승고,차이유통계학의의(P<0.05)；치료후제3개월,A 조 Hb、Hct、SI、TIBC、SF、TSAT균고우B조,차이유통계학의의(P<0.05)。각조환자 EPO 용량비치료전하강,차이유통계학의의(P<0.05)；A조치료후 EPO 용량야명현저우 B조화 C조,차이유통계학의의(P<0.05)。결론생혈저연합좌잡니정보조치료혈액투석환자신성빈혈,능명현개선환자빈혈상황,감소불량반응발생,병차가이감소 EPO용량。
Objective To investigate the efficacy of Shengxuening tablets combined with Levoc-arnitine in treatment of renal anemia.Methods Ninety-six cases of maintenance hemodialysis (MHD) patients were randomly divided into three groups,given withfolic acid and vitamin B12,and subcuta-neous inj ection of recombinant human erythropoietin (EPO)as the basic treatments.Additionally,the patients in group A were given Shengxuening tablets (0.5 g,three times every day)and levocarnitine (intravenous inj ection of 1 g dissolved in 2 mL normal saline for 3-5 min).The patients in group B were given ferrous succinate (0.2 g,3 times every day)and levocarnitine.The patients in group C were given ferrous succinate (0.2 g,3 times every day).During the treatment course,other ferrous reagents and drugs influencing iron metabolism were not administered.After consecutive treatment for 12 weeks,the efficacy was observed.Results After treatment,hemoglobin (Hb),hematocrit (Hct), serum iron (SI),total iron binding force (TIBC),serum ferritin (SF),and transferrin saturation (TSAT)were significantly increased in all groups as compared with those before treatment (P<0.05).After treatment for 3 months,Hb,Hct,SI,TIBC,SF and TSAT in group A were signifi-cantly higher than in group B (P<0.05).The usage of EPO in all groups was significantly reduced after treatment as compared with that before treatment (P<0.05).The dosage of EPO in group A was significantly less than that in groups B and C (P<0.05 ).Conclusions The combined use of Shengxuening with levocarnitine for renal anemia in MHD patients can significantly improve the ane-mia state,reduce the incidence of adverse reactions,and increase the dosage of EPO.