左旋肉碱对腹膜透析患者微炎症状态的影响

目的探讨左旋肉碱（L-CN）对持续不卧床腹膜透析（CAPD）患者微炎症和营养状态的影响。方法选择我院肾内科透析龄超过3个月的CAPD患者39例，将其随机分为观察组和对照组。观察组给予静脉注射L-CN（每次1g、每周3次，共16周）。治疗前后检测超敏C-反应蛋白（hs—CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α），同时测定血清白蛋白、前白蛋白、血红蛋白、转铁蛋白、肌酐、尿素氮、钙、磷等生化指标。并用改良主观全面营养评价法（MSGAN）对患者进行微炎症和营养状态评估。结果观察组治疗后炎症因子hs-CRP、IL-6、TNF-α较治疗前均降低，血清白蛋白、前白蛋白、血红蛋白、转铁蛋白较治疗前升高，两组比较，差异具有统计学意义。而治疗前后肌酐、尿素氮、钙、磷的差异无统计学意义。结论左旋肉碱可改善CAPD患者的微炎症和营养状态。

Effects of L-carnitine on microinflammatory state in peritoneal dialysis patients

Objective To explore the effects of L-carnitine（L-CN） on microinflammatory state and malnutrition in the patients subject to peritoneal dialysis（CAPD）. Method Thirty-nine peritoneal dialysis patients selected from Department of Nephrology of our hospital were randomly divided into observation group（n = 20） and control group（n = 19）. 1.0g L-CN was given to the patients in observation group,three times weekly for 16 weeks. High-sensitive C-reactive protein（hs-CRP）, interleukin-6 （IL-6）,tumor necrosis factor-a（TNF-a）, was done to evaluate the microinflammatory and nutritional status, the serum levels of albumin（ALB）, prealbumin （PA）, hemoglobin （HB）, transferring （Tf）, creatinine（SCr）, urea nitrogen（BUN）, calcium （Ca）, and phosphorus （P） were detected before and after treatment, the modified quantitative subjective global assessment of nutrition（MSGAN）. Result In the observation group, hs-CRP, IL-6, TNF-α were significantly decreased（P〈0. 01）, and the mean serum values of ALB, PA, HB and Tf were significantly increased（P〈0. 01, P〈0. 05） as compared with those before treatment and in control group. There were no significantly differences in serum SCr, BUN, Ca and P before and after treatment. Conclusion L-CN can improve the microinflammatory state as well as malnutrition in CAPD patients.