Efficacy of Recombinant Human Erythropoietin Combined with Levocarnitine in the Treatment of Renal Anemia in Patients with Maintenance Hemodialysis and Its Influence on Inflammatory Factors and Iron Metabolism
ZHANG Zhiqiu, FAN Jihui
Huaibei People's Hospital, AnhuiHuaibei 235000, China
Abstract：Objective: To observe the therapeutic effect of taking combination of recombinant human erythropoietin (rHuEPO) and levocarnitine as treatment regimen on renal anemia caused by maintenance hemodialysis, and to record the influence on serum inflammatory factors and iron metabolism. Methods: A total of 113 patients with renal anemia who underwent hemodialysis in the hospital from January 2019 to January 2021 were selected as the study subjects. 57 cases were included in observation group and 56 cases in control group by adopting non-randomized controlled trial design. Both groups were treated with rHuEPO, folic acid and other drugs, and the observation group was added with levocarnitine after dialysis. After 3 months of treatment, the therapeutic effect of renal anemia of both groups was recorded. Serum inflammatory factors [interleukin-6 (IL-6), C-reactive protein (hs-CRP), tumor necrosis factor α (TNF-α)], serum iron metabolism parameters [serum transferrin receptor (sTfR), serum ferritin (SF), transferrin saturation (TAST)] and oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD)] were compared before treatment and 3 months after treatment. The adverse reactions (gastrointestinal reactions, abnormal liver function, elevated blood pressure, fever) were recorded within 3 months of treatment. Results: The total effective rate of renal anemia treatment of 82.46% in the observation group after 3 months of treatment was higher than 66.07% in the control group (P<0.05). Compared with before treatment, serum inflammatory factors (IL-6, hs-CRP, TNF-α), some iron metabolism parameter (sTfR) and some oxidative stress indicator (MDA) were reduced after 3 months of treatment in both groups, and the reductions were greater in the observation group compared with those in the control group (P<0.05). After 3 months of treatment, the levels of some serum iron metabolism parameters (SF, TAST) and some oxidative stress indicator (SOD) were increased in the two group compared to before treatment, and the increases in the observation group were greater in comparison with the control group (P<0.05). Within 3 months of treatment, the total incidence rates of adverse reactions in the two groups were 14.04% and 26.79% respectively (P>0.05). Conclusion: The use of rHuEPO and other drugs combined with levocarnitine for maintenance hemodialysis-induced renal anemia not only has considerable clinical therapeutic effect, but also reduces inflammatory response, regulate iron metabolism and control oxidative response. In addition, it has safety and deserves clinical promotion.
张芝秋, 范吉辉. 重组人促红素联合左卡尼汀治疗维持性血液透析患者肾性贫血疗效及对炎症因子和铁代谢水平的影响[J]. 河北医学, 2023, 29(3): 486-491.
ZHANG Zhiqiu, FAN Jihui. Efficacy of Recombinant Human Erythropoietin Combined with Levocarnitine in the Treatment of Renal Anemia in Patients with Maintenance Hemodialysis and Its Influence on Inflammatory Factors and Iron Metabolism. HeBei Med, 2023, 29(3): 486-491.
2023, Vol. 29 
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