目的探討左卡尼汀糾正維持性血液透析患者腎性貧血效果及對內(nèi)皮素和左室重構(gòu)的影響。方法將安陽市人民醫(yī)院自2010年11月-2014年11月收治的維持血液透析6個月以上的尿毒癥患者206例作為研究對象,隨機分為研究組和對照組各103例,對照組患者給予促紅細胞生成素,研究組患者在對照組治療的基礎(chǔ)上靜脈推注左卡尼汀注射液,治療6個月后,檢測血紅蛋白（Hb）、紅細胞比容（HCT）,測定血清內(nèi)皮素（ET）,并由有經(jīng)驗的超聲診斷醫(yī)師測量左心房內(nèi)徑（LAD）、左心室收縮末期內(nèi)徑（LVDs）、左心室舒張末期內(nèi)徑（LVDd）的變化等。結(jié)果治療后兩組Hb和HCT均明顯升高,ET水平明顯降低,與同組治療前比較差異具有統(tǒng)計學意義（P<0.05）；且研究組患者以上指標的改變水平顯著優(yōu)于對照組,組間比較差異具有統(tǒng)計學意義（P<0.05）；兩組患者治療后LAD、LVDs、LVDd均發(fā)生不同程度的降低,且研究組顯著低于對照組,組間比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論左卡尼汀聯(lián)合促紅細胞生成素治療維持性血液透析患者腎性貧血可提高治療效果,降低血漿內(nèi)皮素水平,有效改善或抑制左室重構(gòu)的發(fā)生和發(fā)展,有效預防心衰的發(fā)生,效果顯著,可推廣使用。

Objective To investigate the effect of L-carnitine on the anemia of renal anemia and its effect on endothelin and left ventricular remodeling in maintenance hemodialysis patients. Methods 206 patients with uremia who underwent hemodialysis for more than 6 months from November 2010 to November 2014 were randomly divided into study group and control group (n=103), control group (n=103). Patients in the study group were treated with intravenous injection of levocarnitine injection on the basis of the control group. After 6 months of treatment, the clinical curative effect of the two groups was observed. Results After treatment, the levels of Hb and HCT were significantly increased, ET levels were significantly reduced, in which the change of patients in the study group was significantly better than the control group (P < 0.05); LAD, LVDs and LVDd of the two groups were different (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). Conclusion L-carnitine combined with erythropoietin in the treatment of renal hemodialysis patients with renal anemia can improve the therapeutic effect, reduce plasma endothelin levels, effectively improve or inhibit the occurrence and development of left ventricular remodeling, effective prevention of heart failure, The effect is remarkable, can promote the use.