目的 研究左卡尼汀联合琥珀酸亚铁对糖尿病肾病血液透析患者肾性贫血的疗效。方法 选择2016年6月—2019年4月河南省洛阳市第三人民医院的100例糖尿病肾病患者作为研究对象，用抽签法随机分为对照组和观察组，每组各50例。对照组口服琥珀酸亚铁片，0.1 g/次，3次/d。观察组在对照组的基础上静脉推注注射用左卡尼汀，1.0 g/次，3次/周。两组均治疗16周。观察两组患者的临床疗效，同时比较两组患者治疗前后的血清铁蛋白、血红蛋白、血细胞比容、血清总胆固醇、C反应蛋白、三酰甘油和尿蛋白排泄率。结果 治疗后，观察组治疗的总有效率为86.00%，明显高于对照组的62.00%，两组比较差异具有统计学意义（P<0.05）。两组治疗后的血清铁蛋白、血红蛋白、血细胞比容均明显升高（P<0.05），且观察组血清铁蛋白、血红蛋白、血细胞比容明显高于对照组（P<0.05）。两组治疗后的血清总胆固醇、C反应蛋白、三酰甘油和尿蛋白排泄率均明显降低（P<0.05）；且观察组上述指标水平显著低于对照组（P<0.05）。结论 左卡尼汀联合琥珀酸亚铁可降低糖尿病肾病血液透析患者肾性贫血炎症反应和血脂，提高疗效。

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

河南省医学科技攻关计划项目（201602168）