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目的探讨静脉用左旋肉碱(l-carnitine,L-CN)在维持性血液透析(maintenance hemodialysis,MHD)患者贫血治疗中的作用。方法选择符合入选标准的MHD患者32例并随机分为2组,L-CN组在对照组治疗基础上于透析结束时由静脉端注射L-CN 1.0克,每周2次,共12周。检测两组治疗前后血红蛋白(hemoglobin,HB)、网织红细胞计数(reticulocyte,RC)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP),血清铁蛋白(serumferritsn,SF)。结果两组治疗前年龄、透析月龄、HB、RC、hs-CRP、SF无明显差异,L-CN组治疗后HB较治疗前显著升高,hs-CRP、SF较治疗后显著降低。治疗后L-CN组HB显著高于对照组,hs-CRP、SF显著低于对照组。RC变化无统计学差异,hs-CRP与SF明显正相关。结论静脉补充左旋肉碱可减轻全身的微炎症状态,延长红细胞寿命,并因此改善肾性贫血。
Objective To investigate the role of intravenous l-carnitine (L-CN) in the treatment of anemia in patients with maintenance hemodialysis (MHD). Methods Thirty-two MHD patients were enrolled and randomly divided into two groups. L-CN group was injected intravenously with L-CN 1.0 g twice a week for 12 weeks at the end of dialysis on the basis of the control group. The hemoglobin (HB), reticulocyte (RC), high-sensitivity C-reactive protein (hs-CRP) and serum ferritin (SF) were measured before and after treatment in both groups. Results There was no significant difference in age, dialysis month, HB, RC, hs-CRP and SF between the two groups before treatment, HB in L-CN group was significantly higher than before treatment, hs-CRP and SF were significantly lower than those before treatment. After treatment, HB in L-CN group was significantly higher than that in control group, hs-CRP and SF were significantly lower than those in control group. RC no significant difference, hs-CRP and SF was significantly positively correlated. Conclusion Intravenous L-carnitine may reduce the systemic micro-inflammatory state, prolong the life span of erythrocytes, and thus improve renal anemia.