目的 研究左卡尼汀聯(lián)合琥珀酸亞鐵對(duì)糖尿病腎病血液透析患者腎性貧血的療效。方法 選擇2016年6月—2019年4月河南省洛陽(yáng)市第三人民醫(yī)院的100例糖尿病腎病患者作為研究對(duì)象，用抽簽法隨機(jī)分為對(duì)照組和觀察組，每組各50例。對(duì)照組口服琥珀酸亞鐵片，0.1 g/次，3次/d。觀察組在對(duì)照組的基礎(chǔ)上靜脈推注注射用左卡尼汀，1.0 g/次，3次/周。兩組均治療16周。觀察兩組患者的臨床療效，同時(shí)比較兩組患者治療前后的血清鐵蛋白、血紅蛋白、血細(xì)胞比容、血清總膽固醇、C反應(yīng)蛋白、三酰甘油和尿蛋白排泄率。結(jié)果 治療后，觀察組治療的總有效率為86.00%，明顯高于對(duì)照組的62.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的血清鐵蛋白、血紅蛋白、血細(xì)胞比容均明顯升高（P<0.05），且觀察組血清鐵蛋白、血紅蛋白、血細(xì)胞比容明顯高于對(duì)照組（P<0.05）。兩組治療后的血清總膽固醇、C反應(yīng)蛋白、三酰甘油和尿蛋白排泄率均明顯降低（P<0.05）；且觀察組上述指標(biāo)水平顯著低于對(duì)照組（P<0.05）。結(jié)論 左卡尼汀聯(lián)合琥珀酸亞鐵可降低糖尿病腎病血液透析患者腎性貧血炎癥反應(yīng)和血脂，提高療效。

Objective To study the effect of levocarnitine combined with ferrous succinate on renal anemia in patients with diabetic nephropathy undergoing hemodialysis. Methods Patients (100 cases) with diabetic nephropathy in Luoyang Third People's Hospital from June 2016 to April 2019 were divided into control and observation groups randomly, each group had 50 cases. Patients in the control group were po administered with Ferrous Succinate Tablets, 0.1 g/time, three times daily. Patients in the observation group were iv administered with Levocarnitine for Injection on the basis of the control group, 1.0 g/time, 3 times/week. Both groups were treated for 16 weeks. After treatment, the clinical efficacy in two groups were observed, and the serum ferritin, hemoglobin, hematocrit, serum total cholesterol, C-reactive protein, triglyceride, and urinary protein excretion rates in two groups before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 86.00%, significantly higher than 62.00% of the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, serum ferritin, hemoglobin and hematocrit in both groups were significantly increased (P<0.05), and serum ferritin, hemoglobin and hematocrit in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the serum total cholesterol, C-reactive protein, triglyceride, urine protein excretion rates in two groups were significantly reduced (P<0.05). And the level of the above indexes in the observation group was significantly lower than those in the control group (P<0.05). Conclusion Levocarnitine combined with ferrous succinate can reduce the inflammatory reaction and blood lipid of renal anemia in patients with diabetic nephropathy on hemodialysis and improve the curative effect

R977

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201602168）