中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (07): 371-374.doi: 10.3969/j.issn.1671-4091.2013.07.00

• 临床研究 • 上一篇    下一篇

左卡尼汀联合血液透析治疗尿毒症性周围神经病变的临床疗效观察

赵璐杰1,李超林2,邱君3,王建萍1,杨文3   

  1. 1. 山东省烟台毓璜顶医院 血液净化中心
    2.
    3. 烟台毓璜顶医院血液净化中心
  • 收稿日期:2012-12-25 修回日期:2013-05-10 出版日期:2013-07-12 发布日期:2013-07-06
  • 通讯作者: 赵璐杰 E-mail:gump-bear@126.com

Clinical Efficacy of Levocarnitine Combined with Hemodialysis on Treating Uremic Peripheral Neuropathy

  • Received:2012-12-25 Revised:2013-05-10 Online:2013-07-12 Published:2013-07-06

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摘要： 目的 观察左卡尼汀与血液透析联合应用对尿毒症患者周围神经病变的疗效。方法 将烟台毓璜顶医院门诊及住院的84例合并尿毒症性周围神经病变的血液透析患者随机分为常规血液透析对照组（HD，30例）、血液透析滤过治疗组（HDF，27例）、左卡尼汀联合血液透析治疗组（L-CN+HD，27例）。常规血液透析组行每周3次常规血液透析治疗；血液透析滤过组在每周两次常规血液透析的同时，接受每周1次血液透析滤过治疗；左卡尼汀治疗组在常规血液透析基础上给予左卡尼汀2.0g加入0.9%氯化钠溶液250 ml静脉滴注，3次/周。治疗前、治疗后8周分别观察三组患者周围神经病变的临床症状及正中神经、胫神经、腓总神经的感觉神经传导速度(SCV)。结果 三组患者经过8周的充分透析治疗后，左卡尼汀联合血液透析组、血液透析滤过组治疗后周围神经病变的临床症状较对照组明显改善（P＜0.05），治疗后感觉神经传导速度较治疗前有明显改善（ P＜0.01），其程度显著优于血液透析对照组( P＜0.05)，而左卡尼汀联合血液透析组与血液透析滤过组治疗后感觉神经传导速度间比较差异无统计学意义（P＞0.05）。结论 尿毒症性周围神经病变患者在常规HD治疗的同时联合左卡尼汀或血液透析滤过治疗均能有效地改善其周围神经病变，可以根据患者具体情况制定更有经济有效的治疗方法。

关键词: 左卡尼汀, 血液透析滤过, 血液透析, 尿毒症性周围神经病变, 感觉神经传导速度

Abstract: [Abstract] Objective To observe the effect of Levocarnitine combined with hemodialysis in treating uremic perpheral neuropathy. Methods Eighty-four patients with uremic peripheral neuropathy were assigned randomly to hemodialysis group(HD， n＝30),hemodiafiltration group(HDF,n＝27) and Levocarnitine combined with hemodialysis(L-CN+HD,n＝27). The hemodialysis group received regular hemodialysis three times a week.hemodiafiltration group received regular hemodialysis twice a week and hemodiafiltration once a week. Levocarnitine treated group on the basis of regular hemodialysis were given Levocarnitine 2.0g,diluted with 250ml of 0.9% sodium chloride solution,ivgtt,3 times/week)．The treatment lasted 8 weeks.The clinical symptoms and the sensory nerve conduction velocity(SNCV) of median nerve,tibial nerve and peroneal nerve were observed in each group before and after treatment respectively. Results After treatment,the clinical symptoms showed significantly improvement in hemodiafiltration group and Levocarnitine combined with hemodialysis group(P＜0.05).SNCV showed significantly improvement than before treatment(P＜0.01) ，but more significantly improvement than the control group of hemodialysis (P＜0.05). The different in SNCV of hemodiafiltration group and Levocarnitine combined with hemodialysis group was not significantly after treatment（P＞0.05）.Conclusion Uremic peripheral neuropathy patients with conventional HD treatment while combined Levocarnitine or hemodiafiltration therapy can effectively improve peripheral neuropathy, more cost effective treatment can be choosed in accordance with the specific circumstances of the patients.

Key words: Levocarnitine, Hemodiafiltration, Hemodialysis, Uremic peripheralneuropathy, Sensory nerve conduction velocity