血液透析对游离肉碱的清除及影响因素的研究

目的　研究维持性血液透析 (MHD)患者血浆游离肉碱 (FC)水平以及透析对FC清除的影响。方法　应用酶法检测MHD组血浆和透析液中FC水平及对照组尿中FC水平。结果　MHD患者透前血浆FC水平明显低于正常人 (P <0 .0 1)。透析后 ,血浆FC水平较透析前下降 70 %。每周MHD患者透析所致的FC丢失量远远超过对照组尿液排出量 (P <0 .0 1)。透析过程中 ,FC在第 1小时清除最多。透析中FC的清除量与血浆FC浓度呈正相关 (R =0 .5 1,P =0 .0 1)。应用不同透析器及其复用对FC的清除无显著差异。结论　透析中丢失是MHD患者肉碱缺乏的重要原因。应用不同透析器及其复用对FC清除无明显影响。

Effect of hemodialysis on clearance of free carnitine and influencing factors

Objective To investigate effect of maintainable hemodialysis (MHD) on clearance of free carnitine(FC) and influencing factors.Method The FC level in plasma, dialysate and urine was determin ed by enzymatic method.Results MHD patients exhibited si gnificantly lower plasma FC levels than normal subjects (P<0.01), an d after hemodialysis, a marked decrease by 70% in plasma FC was observed. The we ekly FC loss into dialysate was much greater than the weekly urinary FC excretio n in the healthy subjects(P<0.01). During a dialysis session, the amount of FC eliminated into dialysate was higher in the first hour. Plasma FC level correlated positively with the value of FC loss into dialysate (r=0.51,P= 0.01). There was no significantly difference of the loss of FC to dialysate whe n patients were treated with different dialyzers or reused dialyzers. Co nclusions Hemodialysis therapy is a main factor causing carnitine defi ciency. There is no significantly difference of the loss of FC to dialysate whe n patients are treated with different dialyzers or reused dialyzers.