左-卡尼汀对维持性血液透析患者脂质代谢的影响

Effect of L-carnitine on lipid metabolism in maintenance hemodialysis patients

目的探讨左-卡尼汀对维持性血液透析患者脂质代谢的影响。方法对63例维持性血液透析患者于每次透析结束后静脉注射左-卡尼汀1g，共治疗12周。治疗前后测定血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDLC）及其亚组分（HDL2-C，HDL3-C）、低密度脂蛋白胆固醇（LDL-C）、极低密度脂蛋白胆固醇（VLDL-C）等指标。选择同期正常对照组30例。结果治疗组患者血清TG、VLDL-C明显高于对照组，差异有统计学意义（P〈0．01），HDL-C、HDL2-C明显低于对照组，差异有统计学意义（P〈0．01），而TC、HDL3-C和LDL-C两组比较无明显差异（P〉0．05）。治疗后治疗组血清TG、VLDL-C水平下降，治疗前后比较，差异有统计学意义（P〈0．05，P〈0．01），HDL-C、HDL2-C明显增加（P〈0．01），而TC、HDL3-C和LDL-C水平无明显变化（P〉0．05）。结论左-卡尼汀通过降低血清TG、VLDL-C水平，提高HDL-C、HDL2-C浓度改善维持性血液透析患者脂质代谢异常。

Objective To observe the effect of L-carnitine on lipid metabolism in maintenance hemodialysis （MILD） patients. Methods Sixty-three patients who were on MHD were enrolled as a treatment group and treated with intravenous L-carnitine （1 g at the end of each dialysis session） for 12 weeks. The serum levels of total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C） and its subcomponents （HDL2-C, HDL3-C）, low density lipoprotein cholesterol （LDL-C）, and very low density lipoprotein cholesterol （VLDL-C） were measured pre- and post-treatment in treatment group. At the same time, 30 normal healthy people served as a control group. Results The serum levels of TG and VLDL-C were higher significantly, HDL-C and HDL2-C were lower remarkably in the treatment group than in the control group （P〈0. 01）. However, there was no significant difference in serum levels of TC, HDL3-C and LDL-C between the two groups （P〉0. 05）. After treatment, the serum levels of TG and VLDL-C were decreased remarkably and HDL-C and HDL2-C increased significantly in the treatment group （P〈0. 05 or P〈0. 01）, but there was no significant difference in serum levels of TC, HDL3-C and LDL-C pre- and post-treatment （P〉0. 05）. Conclusions Treatment of MHD patients with supplementary L-carnitine improves dyslipidemia by reducing serum levels of TG, VLDL-C and increasing serum levels of HDL-C and HDL2-C.