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目的探究常规透析疗法联合左卡尼汀治疗尿毒症周围神经病变对患者临床症状缓解和神经改善状况。方法2009-11—2013-09来我院就诊的尿毒症周围神经病变患者78例为研究对象,对照组27例(34.62%)采用常规血液透析疗法(HD),治疗A组20例(25.64%)采用血液透析滤过疗法(HDF),治疗B组31例(39.74%)采用血液透析联合左卡尼汀治疗。观察患者临床症状表现及神经传导速度,对比3组患者的临床症状缓解和神经改善状况。结果治疗组与对照组在指端疼痛、感觉障碍、麻木感及不宁腿综合征临床改善方面差异有统计学意义(P<0.05),但治疗A、B组间无差异(P>0.05)。在β2-MG清除率和症状缓解时间,治疗组和对照组间差异有统计学意义(P<0.05),虽治疗A组缓解时间少于治疗B组,但无差异(P>0.05)。在神经速度改善方面,3组治疗前后均存在差异(P<0.05)。3组神经改善方面存在差异(χ2=23.800,P=0.000<0.01)。结论常规HD疗法联合左卡尼汀可以缓解临床症状,改善神经传导状况,且经济高效,可作为治疗参考措施。
Objective To investigate the clinical symptoms and neurological improvement of conventional dialysis combined with levocarnitine in treatment of uremic peripheral neuropathy in patients. Methods A total of 78 patients with uremic peripheral neuropathy treated in our hospital from November 2009 to November 2013 were selected as control group. Twenty-seven patients (34.62%) in control group received routine hemodialysis (HD) and 20 patients (25.64% ) Hemodiafiltration (HDF) treatment group B 31 cases (39.74%) hemodialysis combined with levocarnitine treatment. Clinical symptoms and nerve conduction velocity were observed. The clinical symptoms and neurological improvement were compared between the three groups. Results There was significant difference between the treatment group and the control group in the clinical improvement of finger pain, sensory disturbance, numbness and restless legs syndrome (P <0.05), but there was no significant difference between treatment group A and B (P> 0.05) . There was no significant difference between the treatment group and the control group in the clearance rate of β2-MG and the time of symptom relief (P <0.05). Although the treatment group A had less remission time than the treatment group B, there was no difference (P> 0.05). In the improvement of nerve speed, there were differences in the three groups before and after treatment (P <0.05). There were differences in neurological improvement in the 3 groups (χ2 = 23.800, P = 0.000 <0.01). Conclusion Conventional HD therapy combined with levocarnitine can relieve clinical symptoms and improve the status of nerve conduction, and is cost-effective and can be used as a reference measure for treatment.