目的 探討生血寧片聯(lián)合促紅細(xì)胞生成素和左卡尼汀治療腎性貧血的臨床療效。方法 選取2015年2月-2015年10月成都新華醫(yī)院腎內(nèi)科收治的腎性貧血患者94例,隨機(jī)分為對(duì)照組和治療組,每組各47例。對(duì)照組sc重組人促紅素注射液(CHO細(xì)胞),根據(jù)促紅細(xì)胞生成素使用指南來調(diào)整藥量;并在透析結(jié)束后iv注射用左卡尼汀,1g加入到生理鹽水20mL中。治療組在對(duì)照組基礎(chǔ)上口服生血寧片,2片/次,3次/d。兩組患者均連續(xù)治療3個(gè)月。觀察兩組患者臨床療效,比較貧血和鐵代謝指標(biāo)及氧化應(yīng)激水平變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為87.23%、97.87%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的血紅蛋白(Hb)、紅細(xì)胞壓積(HCT)、轉(zhuǎn)鐵蛋白飽和度(TSAT)及鐵蛋白(SF)均明顯升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組的這些觀察指標(biāo)改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者晚期氧化蛋白產(chǎn)物(AOPP)、丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽過氧化物酶(GSH-Px)水平均明顯升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組AOPP和MDA水平升高幅度低于較對(duì)照組,但SOD和GSH-Px水平改善幅度高于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 生血寧片聯(lián)合促紅細(xì)胞生成素和左卡尼汀治療腎性貧血的臨床療效較好,能明顯改善貧血和鐵代謝,緩解氧化應(yīng)激反應(yīng),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Shengxuening Tablets combined with erythropoietin and levocarnitine in treatment of renal anemia. Methods Patients (94 cases) with renal anemia in Department of Nephrology, Chengdu Xinhua Hospital from February 2015 to October 2015 were randomly divided into the control and treatment groups, and each group had 47 cases. Patients in the control group were sc administered with Recombinant Human Erythropoietin Injection (CHO cells), and the dose was adjusted according to erythropoietin guideline. And they were iv administered with Levocarnitine for injection after the end of dialysis treatment, 1 g was added into normal saline 20 mL. The patients in the treatment group were po administered with Shengxuening Tablets on the basis of control group, 2 tablets/time, three times daily. Patients in two groups were treat for 3 months. After treatment, the clinical efficacies were evaluated, and the indexes of anemia and iron metabolism, and oxidative stress levels in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 87.23% and 97.87%, respectively, and there was difference between two groups (P< 0.05). After treatment, Hb, HCT, TSAT, and SF in two groups were significantly increased, and the differences were statistically significant in the same group (P< 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the levels of AOPP, MDA, SOD, and GSH-Px in two groups were significantly increased, and the differences were statistically significant in the same group (P< 0.05). After treatment, the increased levels of AOPP and MDA in the 收稿日期:2016-01-21 作者簡(jiǎn)介:曾玲玲(1978-),女,本科,主治醫(yī)師,研究方向?yàn)槟I臟內(nèi)科。Tel: 13668158005 E-mail: zll8005@163.comtreatment group were lower than those in the control group, but the increased levels of SOD and GSH-Px in the treatment group were higher than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Shengxuening Tablets combined with erythropoietin and levocarnitine has clinical curative in treatment of renal anemia, and can obviously improve anemia and iron metabolism, and alleviate the oxidative stress reaction, which has a certain clinical application value.