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左旋卡尼汀治疗维持性血液透析患者肉碱缺乏症的临床研究
引用本文:季大玺,谢红浪,梅长林. 左旋卡尼汀治疗维持性血液透析患者肉碱缺乏症的临床研究[J]. 中华肾脏病杂志, 1999, 0(3): 181-184
作者姓名:季大玺  谢红浪  梅长林
作者单位:南京军区南京总医院解放军肾脏病研究所,上海医科大学附属华山医院肾脏病科
摘    要:目的研究静脉注射左旋卡尼汀对维持血液透析(HD)患者肉碱缺乏症的治疗作用。方法采用多中心、双盲、随机、对照的研究方法,选择HD患者197例,分为治疗组、对照组和开放组,每次透析结束后,治疗组和开放组静脉注射左旋卡尼汀1g,对照组注射生理盐水,为期3个月。结果治疗组和开放组体力、精神状态、食欲、恶心、呕吐、透析耐受性、透析中肌痉挛或低血压等症状的改善十分显著,血浆肉碱浓度明显升高(治疗前比治疗后:2882±1258vs.18131±7457,P<001),对照组以上各项均无变化,治疗组与对照组相比变化差异十分显著(P<001);治疗组及开放组血浆总蛋白、白蛋白、前白蛋白和转铁蛋白等营养参数也明显升高。左旋卡尼汀治疗主要不良反应为转氨酶轻度升高和血小板降低,发生率分别为5.3%和2.3%,停药即可恢复正常。结论左旋卡尼汀能安全有效地治疗维持HD患者肉碱缺乏症。

关 键 词:血液透析  肉碱  左旋卡尼汀

Clinical trial of Lcarnitine in maintenance hemodialysis patients
JI Daxi,XIE Honglamg,MEI Changlin,et al.. Clinical trial of Lcarnitine in maintenance hemodialysis patients[J]. Chinese Journal of Nephrology, 1999, 0(3): 181-184
Authors:JI Daxi  XIE Honglamg  MEI Changlin  et al.
Affiliation:JI Daxi*,XIE Honglamg,MEI Changlin,et al.* Institute of Nephrology,Jinling Hospital,Nanjing,210002
Abstract:bjective To investigate the effect of intravenous infusion of Lcarnitine or placebo at the end of each dialysis treatment for 3 months. Methods The trial was multicenter, double blind, placebo controlled and randomized. One hundred and ninetyseven maintenance hemodialysis patients were divided into three groups: treatment group(n=65), control(n=65) and open(n=67) group. In treatment and open group, 1g of Lcarnitine was infused to the patients at the end of each dialysis treatment for 3 months, while normal saline was given to the control group. Serum free carnitine level, clinical and laboratory parameters were studied . Results Serum carnitine level, physical and mental status, nausea and vomiting, dialysis tolerance, intradialytic hypotension and cramps were improved significantly in the treatment and open groups but not observed in placebo group. And serum albumin, proalbumin, and transferrin were also elevated in the treated groups. Conclusion Intravenous supplement of Lcarnitine in hemodialysis patients appears to be associated with an improvement of clinical status, decrease of intradialytic symptoms, sense of well being and certain serum nutritional indexes.
Keywords:emodialysisCarnitineLcarnitine  
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