左卡尼汀对维持性血液透析患者微炎性反应状态相关炎性因子的影响

目的探讨静脉注射左卡尼汀(L-CN)对维持性血液透析(MHD)患者微炎性反应状态相关炎性因子的影响。方法选择透析龄大于6个月的MHD患者76例,随机分为治疗组40例,对照组36例,治疗组于每次透析结束时静脉注射左卡尼汀1g,对照组静脉注射等量生理盐水,治疗3个月,分别检测治疗前及治疗1个月、3个月时MHD患者的血生化指标、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)水平变化。结果治疗1个月后治疗组hs-CRP、IL-6、IL-8、TNF-α水平均较治疗前下降(P均<0.05),对照组治疗前后无显著性差异(P均>0.05),治疗组与对照组比较差异有统计学意义(P<0.05);治疗3个月后治疗组hs-CRP、IL-6、IL-8、TNF-α水平均较治疗前进一步下降(P均<0.01),对照组仍无显著性差异(P均>0.05),治疗组与对照组比较差异有统计学意义(P<0.01)。结论左卡尼汀可以降低维持性血液透析患者血清hs-CRP、IL-6、IL-8、TNF-α水平,改善微炎性反应状态。

Influence of levocarnitine on microinflammation status and associated inflammatory factors in maintenance hemodialysis patients

Objective To study the effects of levocamitine(L-CN)by intravenous injection on microinflammation status and associated inflammatory factors in maintenance hemodialysis(MHD)patients.Methods Seventy-six maintenance hemodialysis(>6 months)patients were enrolled,and the patients were randomly divided into treatment group(n=40) and control group(n=36).Patients in the treatment group were injected with levocarnitine(1.0g)after every dialysis for three months,while patients in the control group accepted normal saline.The blood biochemical indicators,serum hs-CRP, IL-6,IL-8,TNF-a levels were measured and compared at the experiment onset,1 month and 3 months later.Results The hs-CRP,IL-6,IL-8,TNF-a levels were obviously decreased in the treatment group after 1 month(all P<0.05),and they were all significantly difference between treatment and control groups(all P<0.05).But there were no significant difference in control group(all P>0.05).All markers in the treatment group were decreased further after 3 months(all P<0.01), and the difference between two groups was more significant(all P<0.01),and there were still no significant difference in control group(all P>0.05).Conclusion It demonstrated that the levocamitine could reduce the serum level of hs-CRP,IL- 6,IL-8,TNF-α,and improve the microinflammation status in maintenance hemodialysis patients.