卡尼汀的生物学作用及在血液透析患者中的临床应用

卡尼汀是长链脂肪酸进入线粒体进行氧化所必需的一种物质，其左旋异构体具有生物活性。正常人可通过饮食摄入和肝、肾合成产生卡尼汀，但尿毒症血液透析患者由于肾脏内源性合成卡尼汀减少，血液透析过程中大量清除，大多存在时间依赖性的卡尼汀缺乏。通过静脉注射、口服、透析液补充外源性左旋卡尼汀有利于纠正脂代谢紊乱，减少促红细胞生成素用量，改善骨骼肌症状和营养状态，提高生活质量。

The biological effects of carnitine and its clinical value in hemodialysis patients

L carnitine(the active isomer of carnitine) is essential to transfer long chain fatty acid acrosses the mitochondrial membrane to undergo beta oxidation.Carnitine can be absorbed from food and synthesized by liver or kidney in healthy persons.However,time dependent carnitine deficiency is often occurred in patients receiving hemodialysis because of its decrease in kidney synthesis and increase in clearance by hemodialysis.The lipid metabolism disorder,muscular syndromes,and malnutritional state of these patients can be improved by receiving oral or intravenous exogenousL carnitine and the dosage of erythropoetin can also be decreased at the same time.The pharmacokinetic properties ofL carnitine in hemodialysis patients are different from those of healthy persons,so the optimal doses and dosage regimens for these patients remain to be unified.