左卡尼汀对改善维持性血液透析患者营养不良及微炎症状态的临床研究

Clinical study of levocarnitine improving malnutrition and microinflammation state of maintenance hemodialytic patients

目的:观察静脉注射左卡尼汀对维持性血液透析患者(MHD)营养状态及微炎症状态指标的影响。方法:选择透析龄超过3月的MHD患者40例,随机分为治疗组22例,对照组18例。治疗组每次结束透析时静脉注射左卡尼汀1 g,对照组注射等量生理盐水,治疗3个月,分别检测治疗前后MHD患者的白蛋白(Alb)、前白蛋白(PA)、血红蛋白(Hb)、身体质量指数(BMI)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平变化。结果:治疗组Alb、PA、Hb和BMI水平均较治疗前明显上升(P<0.05),而CRP、TNF-α和IL-6水平均较治疗前明显下降(P<0.05);对照组Alb、PA、Hb、BMI、CRP、TNF-α和IL-6治疗前后差异无统计学意义(P>0.05)。结论:左卡尼汀能改善MHD患者营养不良及微炎症状态。

Objective： To investigate the effect of levocarnitine on malnutrition and microinflammation state in maintenance hemodialytic（MHD） patients. Methods： Forty maintenance hemodialytic（over 3 months） patients were enrolled and randomly divided into treatment group（n = 22） and control group（n = 18）. Patients in the treatment group were injected levocarnitine（1.0 g） at the end of each dialysis for three months, while the control group accepted normal saline instead. Alb,PA,Hb,BMI,CRP,TNF-αand IL-6 levels were measured at the onset of experiment and 3 months later and compared. Results： In treatment group,Alb,PA,Hb and BMI levels were significantly increased after treatment（P 〈0.05）, while CRP,TNF-α and IL-6 levels were significantly decreased（P 〈0.05）. In control group,these levels had no significant difference before and after treatment（P 〉0.05）.Conclusion： Levocarnitine can improve the malnutrition and microinflammation state of maintenance hemodialytic patients.