左卡尼汀联合血液透析治疗慢性肾功衰疗效及对微炎症状态的影响

目的：观察左卡尼汀对维持性血液透析患者微炎症状态的影响及疗效。方法：慢性肾功能衰竭维持性血液透析患者80例,采用随机数字表法分为观察组和对照组各40例。两组患者均以血液透析治疗,透析频率和时间相同（3次/周,4 h/次）。观察组患者加用左卡尼汀注射液1.0 g＋0.9%氯化钠注射液20 ml,透析后缓慢静注,连用8周。观察两组患者治疗前后血浆白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平变化,比较两组治疗前后症状体征评分变化及药品不良反应。结果：治疗8周后,观察组患者血浆IL-1β、IL-6、TNF-α水平明显降低（P〈0.05）,且明显低于对照组（P〈0.05）;而对照组患者治疗前后无明显变化（P〉0.05）。观察组患者症状体征评分较治疗前明显下降（P〈0.05）,且明显低于对照组（P〈0.05）;而对照组患者治疗前后无明显变化（P〉0.05）。两组患者治疗期间均未发生明显药品不良反应。结论：左卡尼汀用于维持性血液透析患者具有良好的疗效,安全性好,能降低维持性血液透析患者血浆IL-1β、IL-6、TNF-α水平,改善患者的微炎症状态。

Effect of Levocarnitine Combined with Hemodialysis on the Treatment of Chronic Renal Failure and Micro Inflammatory State

Objective： To observe the curative effect of levocarnitine on the treament of micro inflammatory state of maintenance hemodialysis patients （MHP）. Methods：80 cases of MHP with chronic renal failure （CRF）were selected and divided into the observation group and control group with 40 cases in either group respectively by random number table. The patients in the two groups continued their hemodialysis treatment with the same dialysis frequency and time （ 3 times of dialysis frequency a week, with 4 hours per time）. The patients in the observation group were additionally given 20ml combingtion of 1.0g levocarnitine and 0.9% sodium chloride, which was slowly injected after dialysis for 8 weeks. The changes of IL-1β, IL-6 and TNF-α levels in plasma before and after the medical treatment were observed, and symptom score changes and drug adverse reactions of the patients before and after medical treatment were observed as well. Results： After 8 weeks＇ medical treatment, the IL-1β, IL-6 and TNF-α levels in plasma of the patients in the observation group more obviously de- clined than before （ P 〈 0.05 ）, and no obvious changes appeared in the patients of the control group before and after the medical treatment （P 〉 0.05 ）. The IL-1β, IL-6 and TNF-α levels in plasma of the patients in the observation group after the medical treatment were obviously lower than those in the control group （ P 〈 0.05 ）. Meanwhile, the symptom score of patients in observation group more obviously declined than before （ P 〈 0.05 ）, and no obvious changes of patients in the control group appeared before and after the medical treatment （ P 〉 0.05 ）. The symptom score of the patients in the obser- vation group t was much lower after the medical treatmen than that in the control group （ P 〈 0.05 ）. No obvious drug ad- verse reactions appeared in the patients of the two groups during the medical treament. Conclusion：Levocaruitine had its favorable curative effect on MHP with reliable secu