目的 探讨生血宁片联合促红细胞生成素和左卡尼汀治疗肾性贫血的临床疗效。方法 选取2015年2月-2015年10月成都新华医院肾内科收治的肾性贫血患者94例,随机分为对照组和治疗组,每组各47例。对照组sc重组人促红素注射液(CHO细胞),根据促红细胞生成素使用指南来调整药量;并在透析结束后iv注射用左卡尼汀,1g加入到生理盐水20mL中。治疗组在对照组基础上口服生血宁片,2片/次,3次/d。两组患者均连续治疗3个月。观察两组患者临床疗效,比较贫血和铁代谢指标及氧化应激水平变化。结果 治疗后,对照组和治疗组的总有效率分别为87.23%、97.87%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者的血红蛋白(Hb)、红细胞压积(HCT)、转铁蛋白饱和度(TSAT)及铁蛋白(SF)均明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组的这些观察指标改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平均明显升高,同组治疗前后差异具有统计学意义(P<0.05)。治疗后,治疗组AOPP和MDA水平升高幅度低于较对照组,但SOD和GSH-Px水平改善幅度高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 生血宁片联合促红细胞生成素和左卡尼汀治疗肾性贫血的临床疗效较好,能明显改善贫血和铁代谢,缓解氧化应激反应,具有一定的临床推广应用价值。

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 作者简介:曾玲玲(1978-),女,本科,主治医师,研究方向为肾脏内科。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.