左卡尼汀及饮食干预对维持性血液透析患者营养不良的影响

目的探讨左卡尼汀及饮食干预对维持性血液透析患者营养状态的疗效。方法选择维持性血液透析营养不良患者30例，随机分对照组（A组）、饮食干预组（B组）和左卡尼汀组（c组），每组10例；均给予每周3次血液透析治疗，B、C组患者给予饮食干预，C组每次血液透析后静脉注射左卡尼汀，连续观察12周，比如治疗前后体质量指数（BMI）、血总蛋白（TP）、白蛋白（Alb）、前白蛋白（PA）、血肌酐（SCr）、尿素氮（BUN）、总胆固醇（Tc）及甘油三酯（TG）的变化。结果A组各项指标治疗前后无显著差异（P〉0．05）；B组BMI、TP、Alb、PA、SCr、BUN、TC及TG在治疗前后有统计学差异（P〈0．05）；C组BMI、TP、Alb、PA、SCr及BUN治疗前后有统计学差异（P〈0．05）；C组BMI、TP、Alb、PA、SCr及BUN较B组升高更明显（P〈0．05）。结论通过充分的血液透析、饮食干预及左卡尼汀治疗能显著改善维持性血液透析患者的营养状态。

Effects of L-carnitine and dietary interventions on maintenance hemodialysis patients with malnutrition

Objective To investigate the effect of L-carnitinel and diet intervention on nutrition- al status of maintenance hemodialysis patients. Methods Malnourished patients receiving maintenance hemodialysis in our hospital were randomly divided into control group （A）, Dietary intervention group （B） and L-carnitine group（C）. The patients recieved hemodialysis three times a week. The patients in groups B and C were subjected to the dietary intervention, and those in group C to intravenous injection of L-carnitine （1.0 g） after each hemodialysis for 12 weeks. The changes in BMI, TP, Alb, PA, SCr, BUN, TC and TG before and after treatment were compared and analyzed. Results There were no sig- nificant differences in indicators before and after treatment in group A. There were significant differ- ences in BMI, TP, Alb, PA, SCr, BUN, TC and TG before and after treatment in group B （P〈0. 05）, and BMI, TP, Alb, PA, SCr and BUN in group C （P〈0. 05）. As compared with group B, BMI, TP, Alb,PA,SCr and BUN were increased more significantly in group C than in group B （P〈0. 05）. Con- clusions Adequate hemodialysis in combination with dietary intervention and L-carnitinel treatment can significantly improve the nutritional status of maintenance hemodialysis patients.