目的观察联合应用促红细胞生成素﹙EPO﹚与左卡尼汀和单纯应用EPO治疗慢性肾功能衰竭行维持性血液透析患者贫血的疗效。方法将43例行维持性血液透析治疗的慢性肾功能衰竭并发贫血患者分为治疗组22例和对照组21例,在血透结束前将治疗药物直接注射到透析器的静脉端,治疗组予EPO和左卡尼汀、对照组单纯予EPO,根据患者贫血改善情况调整药物用量;疗程3个月。结果用药后,两组患者血生化指标均较治疗前有所改善,其中治疗组Hb、Hct、Alb水平均较治疗前明显升高,TC和TG水平明显下降,差异均有统计学意义(P<0.01),而且与对照组比较差异亦均有统计学意义(P<0.05);但对照组治疗前后血生化指标差异无统计学意义(P>0.05)。治疗后,两组患者的心率、平均动脉压均较治疗前下降;乏力、食欲不振、心前区不适等临床表现均较治疗前明显好转。治疗组EPO用量较对照组明显减少,差异有统计学意义(P<0.01)。结论联合应用EPO与左卡尼汀可明显提高慢性肾功能衰竭并发行贫血患者的维持性血液透析治疗效果。 Objective To observe the curative effect of combined application of erythropoietin (EPO) and levocarnitine and EPO alone in patients with chronic renal failure who underwent maintenance hemodialysis. Methods Forty-three patients with chronic renal failure and anemia who underwent maintenance hemodialysis were divided into treatment group (n = 22) and control group (n = 21). The therapeutic drugs were directly injected into the venous end of dialyzer before hemodialysis. EPO and levocarnitine, the control group was treated with EPO only, and the dosage of drugs was adjusted according to the improvement of anemia in patients. The course of treatment was 3 months. Results After treatment, the blood biochemical indexes in both groups were improved compared with that before treatment. The levels of Hb, Hct and Alb in treatment group were significantly higher than those before treatment, and the levels of TC and TG were significantly decreased (P (P <0.05). However, there was no significant difference in blood biochemical parameters between the two groups before and after treatment (P> 0.05). After treatment, the heart rate and mean arterial pressure in both groups decreased compared with those before treatment. The clinical manifestations such as fatigue, loss of appetite and precordial discomfort were significantly improved compared with those before treatment. EPO dosage in the treatment group was significantly lower than that in the control group, with significant difference (P <0.01). Conclusion The combination of EPO and L-carnitine can significantly improve the maintenance hemodialysis treatment in patients with chronic renal failure and anemia.