左旋卡尼汀对血液透析患者脂联素及炎症介质的影响

目的探讨左旋卡尼汀（L—CN）对维持性血液透析（MHD）患者脂联素（APN）及炎症介质的影响、方法80例MHD患者分为治疗组和对照组，每组各40例，治疗组应用L—CN1．0g溶于20mL生理盐水中于血液透析结束后静脉注射，每周3次，对照组予一般治疗，疗程12周，治疗前后检测血清APN、TNF－α、IL－6、L-CN等相关指标。结果治疗组应用L—CN12周后，随着L—CN水平升高，TNF—α及IL－6也明显低于对照组（P〈0．01），APN水平治疗前后两组比较差异无统计学意义（P〉0．05）。结论MHD患者静脉应用L—CN可能提高了APN受体的表达．改善MHD患者APN部分被抑制现象，减轻微炎症状态，有利于发挥APN的心血管保护作用。

Effect of L-carnitine on adiponectin and inflammatory mediators in patients undergoing maintenance hemodialysis

Objective To observe the effect of L-carnitine （L-CN） on adiponectin（APN） and inflammatory mediators in patients undergoing maintenance hemodialysis （MHD）. Methods We choosed 80 cases from patients undergoing MHD as the patient group. All cases in the patient group were divided into the treatment group and the control group, as 40 cases in each group. In the treatment group, with the frequency of three times a week, L-CN 1.0g dissolved in 20mL saline were intravenous injected slowly at the end of the hemodialysis. All cases in control group were given general treatment. After 12 weeks of treatment, the levels of APN, TNF-α, IL-6, L-CN were detected before and after the treatment. Results During the application of L-CN of 12 weeks, the higher level of L-CN in the treatment group, the lower level of TNF-α and IL-6 than those in the control group （P 〈 0.01）. There were no significant differences on the APN levels before and after treatment （P 〉 0.05）. Conclusion Intravenous application of L-CN in MHD patients may increase the expression of APN receptor, improve the phenomenon of APN partly inhibited and alleviate the state of inflammation. Furthermore, APN can be more conductive to play the cardiovascular protective effects.