左卡尼汀口服液对2型糖尿病肾病的治疗作用及体内代谢研究

目的使用高效液相色谱法(high performance liquidchromatography,HPLC)检测糖尿病肾病病人体内左卡尼汀(L-carnitine,LC)、乙酰左卡尼汀(acetyl-L-carnitine,ALC)、丙酰左卡尼汀(propionyl-L-carnitine,PLC)含量的变化,观察左卡尼汀口服液对2型糖尿病肾病患者的治疗作用以及其与药物代谢之间的关系。方法 40例早期及临床糖尿病肾病患者随机分为治疗组、对照组(各20例),两组均给予糖尿病常规治疗,治疗组加用左卡尼汀口服液(1 g,Bid),疗程为4周。观察治疗前、后2组患者GLU、TG、CHO、LDL-C、HDL-C、BUN、Cr、UA、尿PRO的变化以及体内卡尼汀群的经时变化和代谢情况。结果 (1)治疗组给药4周后,与治疗前和对照组比较GLU、TG、CHO、LDL-C明显降低,HDL-C明显升高(P<0.01或P<0.05);(2)治疗组用药4周后血BUN与用药前比较明显下降(P<0.05),尿PRO与治疗前和对照组同期比较均明显改善(P<0.01);(3)血浆LC、ALC、PLC浓度与给药前和对照组同期比较浓度明显升高(P<0.01),血浆LC浓度给药4周比给药2周明显升高(P<0.01)。结论左卡尼汀口服液用于2型糖尿病肾病患者的治疗,能明显提高患者体内卡尼汀群的血药浓度,明显改善GLU、TG、CHO、LDL-C、HDL-C、BUN、PRO等临床指标。

The metabolism and effect of L-carnitine oral liquid on type 2 diabetic nephropathy

Aim To detect the contents of L-carnitine(LC),acetyl-L-carnitine(ALC) and propionyl-L-carnitine(PLC) in plasma of diabetic nephropathy(DN) patients by HPLC,and observe the metabolism and effect of LC oral liquid on type 2 diabetic nephropathy.Methods 40 cases of early and clinical diabetic nephropathy were randomly divided into two groups(n=20).Both groups were given diabetes conventional treatment,and the treatment group were additionally administered L-carnitine oral liquid(1 g,bid) for 4 weeks.The level changes of GLU,TG,CHO,LDL-C,HDL-C,BUN,Cr,UA and urine protein before and after LC treatment were observed and the changes and metabolism of L-carnitine(LC) and its acyl esters(ALC,PLC) were detected.Results(1) After treatment with LC for 4 weeks,the contents of GLU,TG,CHO and LDL-C were decreased significantly compared with control group;while HDL-C was increased markedly(P<0.01 or P<0.05);(2) After the administering of LC for 4 weeks,the content of BUN was decreased significantly(P<0.05);treatment with LC significantly reduced the level of urine protein excretion compared with control group(P<0.01);(3) Compared with the control group,LC,ALC and PLC levels were increased significantly(P<0.01).Administering of LC for 4 weeks significantly elevated the concentration of plasma LC compared with the concentration of plasma LC after 2 weeks treatment.Conclusions L-carnitine oral liquid can improve the symptoms of type 2 diabetic patients with nephropathy,increase the concentration of LC,ALC and PLC and regulate blood GLU,TG,CHO,LDL-C,HDL-C,BUN and urinary protein.