左旋卡尼汀治疗维持性血液透析患者卡尼汀缺乏症的临床研究

目的:评价左旋卡尼汀对慢性维持性血液透析患者卡尼汀缺乏症的临床疗效及其药物不良反应。方法:用多中心、随机、对照、单盲方法选择维持性血液透析患者147名,分为试验组、对照组。试验组用Demo公司的左旋卡尼汀,对照组用Sigma-Tau公司的左旋卡尼汀,均每次iv 1g,疗程12周。结果:iv两种左旋卡尼汀均可以显著提高血浆游离卡尼汀水平(P<0.01);同时使患者体力增加,食欲、透析后虚弱感、肌肉痉挛及透析中低血压明显减轻或缓解,两组间比较无显著性差异;在改善血脂代谢、改善患者对r-HuEPO的低反应性方面可能有一定作用。常见药物不良反应为胃肠道反应,可随治疗时间延长减轻或停药后消失。总的药物不良反应发生率两组间比较无显著性差异。结论:左旋卡尼汀能安全有效地治疗维持性血液透析患者卡尼汀缺乏症。

Clinical Effect of L-carnitine on Carnitine Deficiency in Maintenance Hemodialysis Patients

OBJECTIVE: To observe the effects of L-carnitine on carnitine deficiency in maintenance hemodialysis patients. METHODS: The multicenter, randomized, controlled and single blind trial was carried out. One hundred forty-seven maintenance hemodialysis patients were divided into two groups: test group received L-carnitine of Demo and control group received L-carnitine of Sigma-Tau (1g, intravenous injection) at the end of hemodialysis 2 times a week for 12 weeks. RESULTS: Intravenous treatment of both L-carnitine can significantly increased plasma free carnitine level of the patients(P<0.01). Their exercise capacity was increased. And symptoms of anorexia, weakness, muscle cramps and intra-dialytic hypotension were improved significantly as well. There was no significant difference between two groups. This treatment may work on abnormality of lipids metabolism and r-HuEPO hyporesponsiveness. CONCLUSION: Intravenous treatment of L-carnitine was safe and effective on carnitine deficiency in maintenance hemodialysis patients.