尿毒清颗粒联合左卡尼汀对维持性血液透析患者营养不良、微炎症状态及生活质量的影响

Effects of Uremic Clearance Granule Combined with Levocarnitine on Malnutrition, Microinflammation and Quality of Life in Maintenance Hemodialysis Patients

目的探讨尿毒清颗粒联合左卡尼汀在维持性血液透析患者中的应用价值。方法将2015年9月-2018年4月接受维持性血液透析治疗的112例患者以随机数字表法分为对照组56例,观察组56例,对照组给予左卡尼汀,观察组在对照组基础上给予尿毒清颗粒,观察两组治疗前、治疗12周后营养状况、微炎症状态、生活质量变化及不良反应发生情况。结果治疗前,两组营养状况差异无统计学意义(P>0.05),治疗12周后,观察组血红蛋白(HB)、血清前白蛋白(PAB)、血清白蛋白(ALB)与同期对照组对比,明显较高,营养风险筛查评分简表(NR2002)评分与同期对照组对比,明显较低(P<0.05);治疗前,两组微炎症状态差异无统计学意义(P>0.05),治疗12周后,观察组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、超敏-C反应蛋白(hs-CRP)与同期对照组对比,明显较低(P<0.05);治疗前,两组生活质量差异无统计学意义(P>0.05),治疗12周后,观察组健康状况调查简表(SF-36)、肾脏及透析相关生存质量量表(KDTA)评分与同期对照组对比,明显较高(P<0.05);观察组用药后不良反应发生率为10.71%,与对照组7.14%对比,无明显差异(P>0.05)。结论尿毒清颗粒联合左卡尼汀可有效纠正维持性血液透析患者营养不良,缓解微炎症状态,提高生活质量,且高安全性较高,值得推广。

Objective To investigate the value of Uremic Clearance Granule combined with levocarnitine in maintenance hemodialysis patients. Methods Totally 112 patients who underwent maintenance hemodialysis from Sep 2015 to Apr 2018 were randomly divided into control group(56 cases) and observation group(56 cases). The control group was given levocarnitine, and the observation group was given Uremic Clearance Granule on the basis of the control group. We observed the nutritional status, microinflammation status and quality of life before and after 12 weeks treatment and recorded the adverse reactions of the two groups. Results Before treatment, there was no significant difference in nutritional status between the two groups(P>0.05). After 12 weeks treatment, the observation group’s hemoglobin(HB), serum prealbumin(PAB) and serum albumin(ALB) were significantly higher compared with those of the control group. The nutritional risk screening score summary(NR2002) score was significantly lower compared with that of the control group(P<0.05). Before treatment, there was no significant difference in microinflammation status between the two groups(P>0.05). After 12 weeks treatment, the observation group’s serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and hypersensitive C-reactive protein(hs-CRP) were significantly lower compared with those of the control group(P<0.05). Before treatment, there was no significant difference in quality of life between the two groups(P>0.05). After 12 weeks treatment, the observation group’s short form health survey scale(SF-36) and kidney disease-targeted areas scale(KDTA) scores were significantly higher compared with those of the control group(P<0.05). The incidence of adverse reactions in the observation group was 10.71% and no significant difference compared with 7.14% in the control group(P>0.05). Conclusion Uremic Clearance Granule combined with levocarnitine can effectively correct malnutrition in maintenance hemodialysis patients, alleviate microinflammatory state and improve quality of life with high safety, worthy of promoting.