Wanic-Kossowska Maria, Kazmierski Marek, Pawliczak Elzbieta, Kobelski Mikołaj
Klinika Nefrologii, Transplantologii i Chorób Wewnetrznych, Uniwersytet Medyczny im. Karola Marcinkowskiego, Poznań.
Pol Arch Med Wewn. 2007 Jan-Feb;117(1-2):14-9.
The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on selected blood morphology parameters in patients treated with hemodialysis and to assess whether combined therapy could decrease the requirement for exogenous erythropoietin.
The results of anemia treatment were compared in three groups of patients: 27 patients treated with L-carnitine and erythropoietin, 15 patients treated with erythropoietin and 9 patients treated only with L-carnitine. The patients were treated for 6 months. L-carnitine was given orally at a dose of 4 x 250 mg daily. Erythropoietin was administered intravenously after each hemodialysis session and the mean dose of erythropoietin at the beginning of observation was 5642 +/- 2134 units/week. Before treatment serum concentrations of free and total carnitine, parathormone (PTH), aluminium, lead were determined and basic laboratory examinations were performed. The blood morphology was evaluated once a month.
Combined therapy resulted in the improvement of blood morphology parameters (hemoglobin [Hb] before treatment 9.9 +/-1.4 g/dl, during treatment 10.7 +/- 1.6 g/dl), compared to treatment with erythropoietin (Hb before treatment 9.5 +/- 1.2 g/dl, during treatment 9.9 +/- 1.4 g/dl) or L-carnitine alone (Hb before treatment 11.3 +/- 1.0 g/dl, during treatment 12.0 +/- 1.1 g/dl). Combined therapy was associated with the reduction of erythropoietin dosage during treatment from 6287 +/- 1987 units/week to 2286 +/- 1684 units/week. The correlation between serum carnitine concentration and erythrocyte osmotic resistance indicates indirectly the beneficial effect of L-carnitine administration on erythrocyte cell membrane stabilization.
本研究旨在分析左旋肉碱和促红细胞生成素联合治疗对接受血液透析患者特定血液形态学参数的影响，并评估联合治疗是否能降低对外源性促红细胞生成素的需求。
比较三组患者贫血治疗的结果：27例接受左旋肉碱和促红细胞生成素治疗的患者、15例接受促红细胞生成素治疗的患者以及9例仅接受左旋肉碱治疗的患者。患者接受治疗6个月。左旋肉碱口服给药，剂量为每日4×250毫克。每次血液透析后静脉注射促红细胞生成素，观察开始时促红细胞生成素的平均剂量为5642±2134单位/周。治疗前测定血清游离和总肉碱、甲状旁腺激素（PTH）、铝、铅的浓度，并进行基本实验室检查。每月评估一次血液形态。
与促红细胞生成素治疗（治疗前血红蛋白[Hb]为9.5±1.2克/分升，治疗期间为9.9±1.4克/分升）或单独使用左旋肉碱治疗（治疗前Hb为11.3±1.0克/分升，治疗期间为12.0±1.1克/分升）相比，联合治疗使血液形态学参数得到改善（治疗前Hb为9.9±1.4克/分升，治疗期间为10.7±1.6克/分升）。联合治疗与治疗期间促红细胞生成素剂量从6287±1987单位/周降至2286±1684单位/周相关。血清肉碱浓度与红细胞渗透抵抗力之间的相关性间接表明了给予左旋肉碱对红细胞细胞膜稳定的有益作用。
