左卡尼汀减量应用对维持性血液透析患者血清Hep、IL-6水平及贫血状态的影响

Effects of L-carnitine Reduction on Serum Hep,IL-6 Levels and Anemia Status in Maintenance Hemodialysis Patients

目的探讨减少左卡尼汀(L-carnitine,LC)补充后维持性血液透析患者中血清炎性因子水平和肾性贫血的影响和机制。方法选取2021年1月—2021年6月齐鲁医药学院附属医院(新泰市人民医院)60例规律血液透析患者为研究对象,随机分为3组左卡尼汀静脉注射3次/周为LC-3组(20例),静脉注射1次/周为LC-1组(20例)和注射安慰剂LC-0组(20例),随访6个月。对比3组各组临床指标与炎性因子。结果LC-1组给药180 d血浆IL-6(88.50±0.05)ng/L与初始(88.41±0.23)ng/L比较,差异无统计学意义(P>0.05);LC-1组给药180 d的Hep、血红蛋白水平与初始比较,差异无统计学意义(P>0.05)。LC-0组给药180 d血浆IL-6水平较初始明显升高,同时血红蛋白和白蛋白水平较初始降低,差异有统计学意义(P<0.05)。结论停止LC应用达6个月可提高血清Hep及IL-6的水平并加剧肾性贫血的发生。

Objective To explore the effects and mechanisms of reducing serum inflammatory factor levels and renal anemia in maintenance hemodialysis patients after L-carnitine(LC)supplementation.Methods 60 regular hemodialysis patients from the Affiliated Hospital of Qilu Medical College(Xintai People′s Hospital)from January 2021 to June 2021 were selected as the research subjects,randomly divided into three groups:the LC-3 group(20 cases)received 3 weekly intravenous injections of levocarnitine,the LC-1 group(20 cases)received 1 weekly intravenous injection,and the LC-0 group(20 cases)received injecting placebo,followed up for 6 months.Compare clinical indicators and inflammatory factors in three groups.Results There was no statistically significant difference in plasma IL-6 in the LC-1 group at the initial(88.41±0.23)ng/L and after 180 days of administration(88.50±0.05)ng/L(P>0.05).There was no statistically significant difference in Hep and hemoglobin levels in the LC-1 group at the initial and after 180 days of administration(P>0.05).After 180 days of administration,the plasma IL-6 level in LC-0 group significantly increased compared to the initial level,while the hemoglobin and albumin levels decreased compared to the initial level,the difference was statistically significant(P<0.05).Conclusion Discontinuation of LC for 6 months can increase serum Hep and IL-6 levels and aggravate the occurrence of renal anemia.