左卡尼汀联合高通量血液透析改善尿毒症患者贫血及微炎症状态的影响

Effect of L-carnitine combined with high-throughput hemodialysis on anemia and microinflammation in uremic patients

目的探讨左卡尼汀联合高通量血液透析对改善尿毒症患者贫血及微炎症状态的影响。方法回顾性分析2019年1月至2020年1月本院收治的120例尿毒症患者的临床资料,根据不同的治疗方式分为对照组和观察组,每组60例。对照组采用常规透析和左卡尼汀治疗,观察组采用高通量血液透析和左卡尼汀治疗。比较两组治疗前后血常规[红细胞计数(RBC)、血红蛋白(Hb)、血细胞比积(Hct)]、生化指标[血清肌酐(Cr)、尿素氮(BUN)、白蛋白(ALB)、β_(2)微球蛋白(β_(2)-MG)]、微炎症指标[超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子(TNF-α)]及不良反应发生率。结果治疗后,两组RBC、Hb、Hct均高于治疗前,且观察组高于对照组(P<0.05);治疗后,两组Cr、BUN、β_(2)-MG均低于治疗前,且观察组低于对照组,两组ALB均高于治疗前,且观察组高于对照组(P<0.05);两组hs-CRP、IL-6、TNF-α均低于治疗前,且观察组低于对照组(P<0.05);观察组不良反应总发生率为1.67%,低于对照组的13.33%,差异有统计学意义(P<0.05)。结论尿毒症患者采用左卡尼汀联合高通量血液透析治疗可有效改善贫血及微炎症状态,降低不良反应发生率。

Objective To investigate the effect of L-carnitine combined with high-throughput hemodialysis on improving anemia and microinflammation in patients with uremia.Methods The clinical data of 120 patients with uremia admitted to our hospital from January 2019 to January 2020 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,with 60 cases in each group.The control group was treated with routine dialysis and l-carnitine,and the observation group was treated with high-throughput hemodialysis and l-carnitine.Blood routine[(red blood cell count(RBC)),hemoglobin(Hb),hematocrit(Hct)],biochemical indexes[serum creatinine(Cr),urea nitrogen(BUN),albumin(ALB),β_(2) microglobulin(β_(2)-MG)],microinflammatory indicators[sensitive C-reactive protein(hs-CRP),interleukin 6(IL-6),tumor necrosis factor(TNF-α)]before and after treatment and the incidence of adverse reactions were compared between the two groups.Results After treatment,RBC,Hb and Hct in two groups were higher than before,and observation group was higher than control group(P<0.05).After treatment,Cr,BUN,β_(2)-MG in two groups were lower than before treatment,and the observation group was lower than the control group;ALB in two groups were higher than before treatment,and the observation group was higher than the control group(P<0.05);hs-CRP,IL-6 and TNF-αin two groups were lower than before treatment,and observation group was lower than control group(P<0.05);the total incidence of adverse reactions in the observation group was 1.67%,which was lower than 13.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion L-carnitine combined with high-throughput hemodialysis can effectively improve anemia and micro-inflammation and reduce the incidence of adverse reactions in patients with uremia.