左卡尼汀对维持性血液透析患者营养及微炎症状态的影响

目的观察静脉注射左卡尼汀对维持性血液透析（MHD）患者营养及微炎症状态的影响。方法选择MHD时间〉6个月的患者68例，按随机数字表法分为两组，观察组35例每次透析结束后给予左卡尼汀静脉注射，并给予重细人促红细胞生成素、铁剂、叶酸等药物治疗，对照组33例不给予左卡尼汀，其他治疗与观察组相同。分别于治疗前及治疗后3个月检测两组患者胁、ALB、TC、TG、LDL-C、HDL-C等营养指标及超敏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）等炎症指标。结果治疗后观察组血清IIb、虹卫水平均较治疗前明显上升（P〈0．05），且明显高于对照组治疗后的水平（P〈0．05）；观察组治疗前后血清TC、TG、LDL-C、HDL-C水平均无明显变化（P〉0．05），对照组治疗前后血清Hb、ALB、TC、TG、LDL-C、HDL-C水平均无明显变化（P〉0．05）。治疗后观察组hs-CRP、IL-15、IL-8、TNF-α均较治疗前明显下降（P〈0．05），且明显低于对照组治疗后的水平（P〈0．05）；对照组治疗前后hs-CRP、IL-6、IL-8、TNF-α均未发生明显变化（P〉0．05）。结论左卡尼汀能明显改善MHD患者营养状况及微炎症状态。

Effects of Levocarnitine on Nutritional Status and Microinflammatory in Maintenance Hemodialysis Patients

Objective To investigate the effects of levocamitine on microinflanunatomy and nutritional status in maintenance hemodialysis （MHD） patients. Methods Sixty-eight patients suffering from MHD for over six months were randomly divided into two group. The observation group（n = 35） was treated with intravenous injection of levocarnitine as well as recombinant human erythropoietin, chalybeate,felic acid and so on. The control group （n = 33 ） was treated with recombinant human erythropoietin, chalybeate, folic acid and so on, but without levocarnitine. Hemoglobin （Hb）, albumin （ALB）, total cholesterol （ TC ）, triglyceride （ TG）, low density lipoprotein-cholesterol （ LDL-C ）, high density lipoprotein- cholesterol （ HDL-C ）, high- sensitivity C-reactive protein （ hs-CRP ）, interleukin-6 （ IL-6 ）, interleukin-8 （ IL-8 ） and tumor necrosis factor （TNF-ot） were measured in two groups before and three months after treatment. Results The serum levels of Hb and ALB increased significantly in the observation group after treatment compared with those before treatment （P 〈 0. 05 ） , which were significantly higher than the controls after treatment （P 〈 0. 05 ）. The serum levels of TC, TG, LDL-C and HDL-C after treatment showed no significant difference in contrast with those before treatment in the observation group （P 〉 0. 05 ）. The serum levels of Hb, ALB, TC, TG, LDL-C and HDL-C after treatment showed no significant difference in contrast with those before treatment in the control group （P 〉 0.05）. The levels of hs-CRP,IL-6, IL-8 and TNF-α decreased significantly in the observation group after treatment compared with those before treatment （P 〈 0.05 ）, which were significantly lower than the controls after treatment （P 〈 0.05）. The levels of hs-CRP, IL-6, IL-8 and TNF-α after treatment showed no significant difference in contrast with those before treatment in the control group （P 〉0.05）. Conclusion Levocarnitine can significantly improve microinflammation and nutrition status in MHD patients.