左旋肉毒碱对维持性血液透析患者微炎症状态的干预作用研究

Study on L-carnitine Intervening in Micro-inflammatory State in Maintenance Hemodialysis Patients

目的:观察左旋肉毒碱对维持性血液透析(MHD)患者C-反应蛋白(CRP)及营养相关指标的影响,探讨其对MHD患者微炎症的干预作用。方法:66例MHD患者按自愿原则分为治疗组与对照组,治疗组每次血液透析后静脉注射左旋肉毒碱1.0g,对照组不使用左旋肉毒碱。2组其他药治疗相同,研究期为3个月。比较2组治疗前、后CRP和血红蛋白(Hbg)、白蛋白(Alb)、前白蛋白(PAB)、转铁蛋白(Tf)、胆固醇(Tch)及甘油三酯(TG)、脂蛋白(a)(Lp(a))等检测指标的变化。结果:3个月后治疗组CRP水平明显低于治疗前(P<0.01),也明显低于对照组(P<0.01)。与治疗前比较,3个月后治疗组Hbg上升非常显著(P<0.01),Alb、PAB和Tf也有明显上升(P<0.05)。结论:左旋肉毒碱可明显改善MHD患者的微炎症状态和营养状态。

OBJECTIVE： To observe the effect of L-carnitine on C-reactive protein （CRP） and nutrition-related indicators in maintenance hemodialysis （MHD） patients, and to explore intervention effect of L-carnitine on micro-inflammation in MHD patients. METHODS： 66 MHD patients were divided into treatment group and control group. Both groups were given same therapy. Treatment group was addtionally given L-carnitine 1.0 g intravenously after each hemodialysis for 3 months. The change of CRP and hemoglobin （Hbg）, albumin （Alb）, prealbumin （PAB）, transferrin （Tf）, cholesterol （Tch） and triglyceride （TG）, lipoprotein （a）（Lp（a）） were compared between 2 groups before and after treatment. RESULTS： After 3 months, the CRP levels of treatment group were significantly lower than before treatment （P〈0.01） and that of control group （P〈0.01）. Compared with before treatment, Hbg level of treatment group increased significant after 3 months （P〈0.01）. The level of Alb, PAB, and Tf also significantly increased （P〈0.05）. CONCLUSION： L-carnitine can improve the micro-inflammatory state and nutritional status in MHD patients.