替米沙坦联合左卡尼汀对腹膜透析患者氧化应激及微炎症状态的影响

Effects of telmisartan combined with L-carnitine on oxidative stress and micro-inflammation status in peritoneal dialysis patients

目的：探讨替米沙坦联合左卡尼汀对腹膜透析（PD）患者的氧化应激及微炎症状态影响。方法：选择河北北方学院附属第一医院2011年11月～2014年1月80例慢性肾功能衰竭（CRF）接受腹膜透析（PD）患者为研究对象,随机分为治疗组和对照组;两组均常规进行PD,对照组给予左卡尼汀口服液10mL/次、3次/d,治疗组在上述基础上加替米沙坦80mg/次、1次/d,两组均连续服用24周;于治疗前后抽取清晨空腹静脉血5mL,离心取血清。测定超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、脂质过氧化物丙二醛（MDA）、血浆谷胱甘肽过氧化酶（GSH-Px）水平。结果：治疗后hs-CRP、IL-6、IL-8、TNF-α水平均有所降低,治疗组优于对照组,差异有统计学意义（P〈0.05）;治疗后两组MDA降低,GSH-Px升高,治疗组优于对照组,差异有统计学意义（P〈0.05）。结论：替米沙坦联合左卡尼汀可能成为PD患者抑制微炎症状态及氧化应激反应的理想治疗措施,从而减少心血管事件发生的风险,为今后的临床应用提供依据。

Objective：To explore the effects of telmisartan ombined with L-carnitine on the oxidative stress and microinflammation status in peritoneal dialysis（PD）patients.Methods：A total of 80 patients with chronic renal failure（CRF）who were admitted in our hospital from November,2011 to January,2014 for PD were included in the study and randomized into the treatment group and the control group.The patients in the two groups were routinely treated with PD.The patients in the treatment group were given L-carnitine oral liquid,10mL/time,3times/d,and telmisartan,80mg/time,1time/d.The patients in the control group were given L-carnitine oral liquid,10mL/time,3times a day.The patients in the two groups were treated for 24 weeks continuously.A volume of 5mL morning fasting venous blood before and after treatment was extracted,and centrifuged for serum.The levels of hs-CRP,IL-6,IL-8,TNF-α,MDA,and GSH-Px were determined.Results：After treatment,the levels of hs-CRP,IL-6,IL-8,and TNF-αwere reduced,and the reduced degree in the treatment group was significantly superior to that in the control group（P〈0.05）.After treatment,MDA was reduced,GSH-Px was elevated,and the reduced degree and elevated degree in the treatment group were significantly superior to those in the control group（P〈0.05）.Conclusions：Telmisartan combined with L-carnitine can probably become an ideal therapeutic measure for inhibiting the micro-inflammation state and oxidative stress reaction in PD patients,thus reducing the risk of cardiovascular events,which can provide an evidence for the clinical application in the future.