左旋肉碱对维持性血液透析老年患者营养不良及心功能不全的影响

目的 观察左旋肉碱对维持性血液透析(maintenancehemodialysis,MHD)老年患者营养不良、心功能不全的影响.方法 将127例老年MHD患者随机分为治疗组和对照组,治疗组于每次血液透析结束前从静脉缓慢注入左旋肉碱1 g加生理盐水20 ml,共2个月.对照组于结束前静脉注入生理盐水20 ml,频次及疗程同治疗组,疗程共2个月.观察2组治疗前后相关实验室检查及超声心动图检查.结果 治疗组经左旋肉碱治疗2个月后,患者的血清白蛋白、前白蛋白、转铁蛋白、血红蛋白、干体重与治疗前及对照组比较,都有不同程度的增高,其差异均有统计学意义(P<0.01),治疗组随着营养状况改善,与对照组比较,患者LVEF增加,Tei指数下降(P<0.01).结论 左旋肉碱可明显改善老年维持性血液透析营养不良和心功能不全.

Effect of levocarnitine on malnutrition and heart failure in elderly patients receiving hemodialysis

Objective To study the impact of levocarnitine on malnutrition and heart failure in elderly hemodialysis（MHD） patients with malnutrition and heart failure.Methods 127 elderly patients on MHD were randomly divided into treatment group and control group.The treatment group was given levocarnitine 1g by intravenous injection at the end of each hemodialysis.The duration of therapy was 2 months.The control group was given physiological saline by intravenous injection at the end of each hemodialysis.The frequency and duration of therapy were the same in the two groups.Serum albumin,prealbumin,transferrin,hemoglobin,dry weight and echocardiography were measured.Results Serum albumin,prealbumin,transferrin,hemoglobin dry weight were increased in treatment group（P0.01）.As the nutritional status improved,the LVEF in treatment group increased and the Tei index decreased when compared with control group（P0.01）.Conclusions Levocarnitine can significantly improve malnutrition and left ventricular function in elderly hemodialysis patients.