左卡尼汀对腹膜透析患者瘦素及营养状态的影响

Effect of levocarnitine on leptin levels and nutrition status in patients undergoing peritoneal dialysis

目的观察左卡尼汀对腹膜透析(PD)患者血清瘦素(leptin)水平及营养状态的影响。方法 40例PD患者随机分为治疗组和对照组,各20例。治疗组每日给予左卡尼汀1 g,静脉推注,连用6个月;对照组仅给予常规治疗。于治疗前及治疗6个月后检测生化指标、血清瘦素水平及肱三头肌处皮褶厚度(TSF)、上臂肌围(MAMC)、体质量指数(BMI)和改良主观总体评价(SGA)评分;结果治疗6个月后,治疗组患者血清白蛋白(Alb)、血红蛋白(Hb)、前白蛋白(PA)明显升高(P<0.05),leptin与改良SGA评分较治疗前明显下降(P<0.05);治疗前后胆固醇(TC)、甘油三酯(TG)、TSF、MAMC和BMI变化不明显(P>0.05)。结论左卡尼汀能有效降低PD患者血清瘦素水平,改善患者营养状态。

Objective To observe the effect of levocarnitine on serum levels of leptin and nutrition status in patients undergoing peritoneal dialysis（PD）.Methods Forty patients receiving peritoneal dialysis were randomly divided into treatment group and control group,20 patients for each.Levocarnitine was given to treatment group intravenously in a dose of 1 g per day for 6 months,while routine treatment to control group.Both groups were measured for serum albumin（Alb）,prealbumin（PA）,cholesterol（TC）,triglycerides（TG）,leptin,triceps skinfold thickness（TSF）,mid-arm muscle circumference（MAMC）,body mass index（BMI） and modified subjective global assessment（SGA） before treatment and after 6 months of treatment.Results After 6 months of treatment,the serum levels of PA,Alb and Hb increased significantly in treatment group（P〈0.05）,while scores of modified SGA decreased markedly（P〈0.05）.However,there was no significant difference in the levels of TG,TC,TSF,MAMC and BMI between the two groups.Conclusions Levocarnitine could effectively lower the serum level of leptin and improve the nutrition status in PD patients.