左卡尼汀和蔗糖铁对血液透析患者肾性贫血氧化应激的干预作用

目的研究左卡尼汀和蔗糖铁对血液透析患者肾性贫血及氧化应激的影响。方法 80例血液透析患者随机分为对照组（单用蔗糖铁）和治疗组（左卡尼汀＋蔗糖铁）,两组各40例。分别测定两组治疗前及治疗后3、6月贫血指标（Hb、Hct、SF、TSAT）和氧化应激指标（AOPP、MDA）的水平。结果①两组透析患者的贫血指标均低于正常值,AOPP、MDA明显升高。②两组治疗3个月时AOPP、MDA较前增加但无统计学意义（P〉0.05）。两组患者共有75人贫血指标达标。③治疗6个月时对照组MDA、AOPP与治疗前比较明显升高（P〈0.05）,治疗组有上升的趋势（P〉0.05）,治疗组EPO剂量低于对照组（P〈0.05）。结论左卡尼汀和蔗糖铁对血透患者肾性贫血有明显的治疗效果,蔗糖铁加重患者的氧化应激（OS）,而左卡尼汀对OS有明确的缓解作用。

The influence of L-carnitine combined iron sucrose on renal anemia and oxidative stress in hemodialysis patients

Objective To evaluate influence of L-carnitine and iron sucrose on renal anemia and oxidative stress in hemodialysis patients.Methods 80 hemodialysis patients were randomly divided into treatment group（n=40） and control group（n=40）,who therapied renal anemia and oxidative stress by using erythropoietin（EPO） and iron sucrose on the base of hemodialysis.The patients in treatment group received 1g L-carnitine by intravenous injection after each hemodialysis.Hb、Hct、SF、TSAT and plasma levels of malondialdehyde（MDA）、were monitored in 0、3、6 months in two groups.Results（1）The levels of AOPP、MDA in hemodialysis patients were higher than those of normal,but Hb、Hct、SF、TSAT lower normal.（2）Hb、Hct、SF、TSAT of 75 in tow group were in normal in 3months,except for 5 patients.（3）The levels of AOPP、MDA in tow group insignificantly increased（P0.05） in 3 months,AOPP、MDA have discrepancy（（P0.05）in control in 6months;not changed,but had tendency of increase in therapy group in 6months.Conclusion L-carnitine combined iron sucrose have a significant effect on renal anemia;iron sucrose can aggravate OS;L-carnitine can alleviate OS.