左卡尼汀对维持性血液透析患者营养指标及炎症状态的影响

Effects of Levocarnitine on Nutritional and Microinflammatory State in Maintenance Hemodialysis Patients

目的观察左卡尼汀对维持性血液透析(MHD)患者营养指标及炎症状态的影响。方法 2010年10月-2011年10月选择透析中心透析龄>6个月的MHD患者62例,随机分为治疗组32例和对照组30例。两组常规治疗相同,治疗组于每次透析结束后给予静脉注射左卡尼汀1 g,治疗3个月,治疗前后测定血红蛋白(Hb)、白蛋白(Alb)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)等指标并进行评价,观察并记录临床症状改变情况。结果治疗后,治疗组与对照组的Alb、Hb、TG、HDL-C和hs-CRP、透析低血压、肌痉挛、乏力、纳差比较,差异均有统计学意义(P<0.05),TC、LDL-C比较均无统计学意义(P>0.05)。对照组治疗前后Alb、Hb、纳差比较差异均有统计学意义(P<0.05);TC、TG、LDL-C、HDL-C、hs-CRP、透析低血压、肌痉挛和乏力比较,差异均无统计学意义(P>0.05)。治疗组治疗前后Alb、Hb、TG、HDL-C、hs-CRP、透析低血压、肌痉挛、乏力和纳差比较,差异均有统计学意义(P<0.05);TC、LDL-C比较差异均无统计学意义(P>0.05)。结论左卡尼汀可明显改善患者的营养状态、微炎症状态及生活质量。

Objective To observe the effects of levocarnitine by intravenous injection on nutritional and microinflammatory state in maintenance hemodialysis patients.Methods Between October 2010 and October 2011,62 maintenance hemodialysis（ 6 months） patients in our dialysis center were enrolled in this study,and were randomly divided into treatment group（n= 32） and control group（n= 30）.Patients in the treatment group were injected with levocarnitine（1.0 g once） after every dialysis for 3 months,while patients in the control group only accepted routine hemodialysis therapy.Blood biochemical indicators,serum high sensitive C-reactive protein（hs-CRP） were measured and compared at the experiment onset and 3 months later.Results After treatment with levocarnitine for three months,the average serum levels of albumin（Alb）,hemoglobin（Hb）,triacylglycerol（TG）,high density lipoprotein cholesterol（HDL-C） and hs-CRP,and the conditions of dialysis hypotension,muscular spasm,lacking in strength,and anorexia were significantly different between the two groups（P〈0.05）.But there was no significant difference in total cholesterol（TC） and low density lipoprotein cholesterol（LDL-C）between the two groups（P〈0.05）.For the control group,after treatment,Alb,Hb and condition of anorexia changed significantly（P〈0.05）,while TC,TG,LDL-C,HDL-C,hs-CRP,conditions of dialysis hypotension,muscular spasm and lacking of strength did not change（P〉0.05）;for the treatment group,after treatment,all Alb,Hb,TG,HDL-C,hs-CRP,conditions of dialysis hypotension,muscular spasm,lacking of strength and anorexia changed significantly（P〉0.05）,while TC and LDL-C did not change obviously（P〈0.05）.Conclusion Levocarnitine can significantly improve the nutritional and microinflammatory state and better the quality of life in maintenance hemodialysis patients.