Meta-analysis of L-carnitine for maintenance hemodialysis patients with renal anemia
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摘要:
目的系统评价应用左卡尼汀对维持性血液透析患者肾性贫血的影响。 方法采用计算机和手工检索相结合的方法。计算机检索中国知网数据库（CNKI）、中国生物医学文献数据库（CBMdise）、维普期刊数据库、万方数据库、The Cochrane Library 、PubMed、外文生物医学期刊文献数据库，收集关于左卡尼汀治疗维持性血液透析患者肾性贫血的随机对照试验(RCTs)。采用Cochrane协作网提供的的偏倚风险评估工具，对纳入的研究进行质量评价；用RevMan5.0统计软件进行meta分析。 结果共纳入7项RCT，319 例血透患者符合纳入标准。meta分析结果显示：左卡尼汀对血红蛋白水平[MD=-3.30，95%CI（-6.44，-0.17），P=0.04]、红细胞压积[MD=-0.60，95%CI（-1.06，-0.13），P=0.01]及促红细胞生成素用量[MD=-1.71，95%CI（-3.31，-0.12），P=0.04]的作用与对照组相比差异有统计学意义。 结论有确凿的证据表明，应用左卡尼汀对维持性血液透析患者肾性贫血有疗效。 Abstract:ObjectiveTo evaluate the effect of L-carnitine for maintenance hemodialysis patients with renal anemia. MethodsAdopting the method of computer and manual retrieval. Randomized controlled trials（RCTs）involving L-carnitine in the treatment of maintenance hemodialysis patients（MHD）with renal anemia were from CNKI、the Chinese biomedical database (CBM)、VIP database、WanFang Data、The Cochrane Library, PubMed and Foreign Medical Journal Service (FMJS). To evaluate the quality of included studies by the Cochrane-recommended menthod; and data analyses were performed with Cochrane Collaboration's RevMan 5.0. ResultsSeven RCTs (319 participants) were included. The meta-analysis results showed that L-carnitine significantly increased hemoglobin [MD=-3.30, 95CI (-6.44,-0.17), P=0.04]、hematocrit [MD=-0.60, 95% CI（-1.06, -0.13）, P=0.01] and decreased the required erythropoietin dose [MD=-1.71, 95%CI（-3.31,-0.12）, P=0.04]. ConclusionIn this meta-analysis,there is conclusive evidence that L-carnitine can significantly benefit hemodialysis-related renal anemia. -
Key words:
- L-carnitine /
- maintenance hemodialysis /
- renal anemia /
- meta-analysis
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表 1 纳入研究的基线特征
纳入研究 年份 例数 给药方式 剂量 疗程 治疗组 对照组 Labonia et al[14] 1995 13 11 iv 1g 6mo Caruso et al[15] 1998 12 16 iv 1g 6mo Thomas et al[16] 1999 8 7 iv 10mg/kg 4mo Semeniuk[17] 2000 8 8 iv 20mg/kg 7.5mo Brass et al[18] 2001 28 28 iv 20mg/kg 6mo Brass et al[18] 2001 32 11 iv 10mg/kg 6mo Brass et al[18] 2001 30 11 iv 20mg/kg 6mo Brass et al[18] 2001 32 11 iv 40mg/kg 6mo Steiber et al[19] 2006 15 19 iv 20mg/kg 6mo Biolo et al[20] 2008 9 10 iv 20mg/kg 3wk 
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