尿毒清颗粒联合左卡尼汀对维持性血液透析患者肾功能、氧化应激以及微炎症状态的影响

Effect of Niaoduqing granule combined with Levocarnitine on renal function,oxidative stress,and microinflammatory state in patients undergoing maintenance hemodialysis

目的探讨尿毒清颗粒联合左卡尼汀对维持性血液透析患者肾功能、氧化应激以及微炎症状态的影响。方法选取2017年4月至2019年12月期间大连市第六人民医院肾内科收治的80例维持性血液透析患者,按照随机数表法分为对照组和观察组,每组40例。两组均给予血液透析治疗,对照组在此基础上静脉注射左卡尼汀,观察组在对照组治疗基础上加服尿毒清颗粒。均连续用药12周,比较两组患者治疗12周后的疗效、肾功能、氧化应激、微炎症状态及不良反应。结果观察组患者治疗12周后的临床总有效率为87.50%,明显高于对照组的67.50%,差异有统计学意义(P<0.05);观察组和对照组患者治疗12周后的血清白介素-6(IL-6)[(54.59±6.02)ng/L vs(73.98±8.27)ng/L]、尿素氮(BUN)[(13.16±1.23)mg/dL vs(19.31±1.25)mg/dL]、超敏C反应蛋白(hs-CRP)[(4.21±1.17)mg/L vs(7.42±1.41)mg/L]、肌酐(Scr)[(362.09±42.74)μmol/L vs(474.37±36.12)μmol/L]、肿瘤坏死因子-α(TNF-α)[(24.18±3.23)ng/L vs(32.89±4.09)ng/L]、不对称二甲基精氨酸(ADMA)[(6.18±1.55)μmol/L vs(12.49±1.69)μmol/L]、晚期氧化蛋白产物(AOPP)[(31.07±4.26)ng/mL vs(44.93±5.38)ng/mL]水平比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论维持性血液透析患者透析过程中给予尿毒清颗粒联合左卡尼汀治疗可有效改善患者的肾功能、氧化应激以及微炎症状态,临床治疗效果较好,且安全可靠。

Objective To investigate the effect of Niaoduqing granule combined with Levocarnitine on renal function,oxidative stress,and microinflammation state in patients undergoing maintenance hemodialysis.Methods Eighty patients undergoing maintenance hemodialysis who were admitted to Department of Nephrology,Dalian Sixth People's Hospital from April 2017 to December 2019 were selected,which were divided into control group and observation group according to the method of random number table,with 40 patients in each group.Based on hemodialysis,the control group was given Levocarnitine intravenously,and the observation group was given Niaoduqing granules combined with Levocarnitine.All patients were treated for 12 weeks,and then the curative effect,renal function,oxidative stress,microinflammation state,and adverse reactions were compared between the two groups.Results The total effective rate of patients in the observation group treated for 12 weeks was 87.50%,which was significantly higher than 67.50%of in the control group(P<0.05).Compared with the control group,the levels of serum interleukin-6(IL-6),urea nitrogen(BUN),hypersensitive C-reactive protein(hs-CRP),creatinine(Scr),tumor necrosis factor-α(TNF-α),asymmetric dimethyl arginine(ADMA),and late oxidized protein product(AOPP)of the observation group were significantly lower than those of control group(P<0.05):IL-6,(54.59±6.02)ng/L vs(73.98±8.27)ng/L;BUN,(13.16±1.23)mg/dL vs(19.31±1.25)mg/dL;hs-CRP,(4.21±1.17)mg/L vs(7.42±1.41)mg/L;Scr,(4.21±1.17)mg/L vs(7.42±1.41)mg/L;TNF-α,(24.18±3.23)ng/L vs(32.89±4.09)ng/L;ADMA,(6.18±1.55)μmol/L vs(12.49±1.69)μmol/L;AOPP,(31.07±4.26)ng/mL vs(44.93±5.38)ng/mL.There was no significant difference in the incidence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion Niaoduqing granule combined with levocarnitine can effectively improve the renal function,oxidative stress,and microinflammation state of maintenance hemodialysis patients,with good clinical treatment effect,and it is safe and reliable.