维生素E联合左卡尼汀对血液透析患者氧化应激及内皮细胞功能的干预作用

目的 研究维生素E联合左卡尼汀对维持血液透析(MHD)患者氧化应激、内皮细胞功能及营养状态的干预作用.方法 83例MHD患者随机分为对照组(A组),左卡尼汀治疗组(B组),维生素E治疗组(C组),两药联用治疗组(D组).在每次透析结束时B组给予静脉注射左卡尼汀1.0 g,C组每日给予口服维生素E 400 mg,D组联合使用左卡尼汀和维生素E.分别检测各组患者的血生化指标及血浆丙二醛(MDA)、谷胱甘肽过氧化物酶(GSHPx)、一氧化氮(NO).结果 A组3个月末时MDA较透析前增加(4.81±0.08)nmol/L与(4.62±0.06)nmol/L(P<0.05)],第3个月末时GSHPx降低(72.02±2.05)μmol/L与(74.62±1.46)μmol/L(P<0.01)],血红蛋白(Hb)、血白蛋白(Alb)降低,但差异均无统计学意义(P均>0.05).B、C组在3个月时MDA明显低于A组(3.86±0.06)、(3.81±0.19)nmol/L对(4.81±0.08)nmol/L(P均<0.01)],而GSHPx、NO则显著增高(92.11±1.62)、(92.14±1.37)μmol/L对(72.02±2.05)μmol/L;(64.24±1.72)、(64.35±1.67)μmol/L对(49.91±1.19)μmol/L(P均<0.05)].在第3个月时,患者的Hb、Alb水平较治疗前显著升高(P均<0.05).D组效果优于B、C组(P均

The effect of levocarnitine and Vitamin-E on oxidative stress state and the function of endothelial cells in maintenance hemodialysts patients

Objective To study the treatment effects of intravenous levocarnitine in combinaton wlth vitamin-E in the oxidative stress state,endothelial cell function and nutritional status of patients with maintenance hemodialvsis (MHD).Methods 83 patients with MHD were randomized to the control group (Group A),and three treatment groups:with levocarnitine (Group B),with Vitamin-E (Group C),with levocarnitine and Vitamin-E(Gmup D).Intravenous 1.0 g levocarnitine were administered to Group B,oral vitamin-E(200 mg,two times each day) to group C,and vitamin-E and levocarnitine were coadministratered to group D at the end of dialysis.The blood biochemical indicators of each group were measured respectively.At the same time,malondialdehyde(MDA),glutathione peroxidase (GSHPx) and nitricoxide (NO) expression were mesured.Results MDA of group A increased compared with pre-dialysis at the end of the 3rd month(4.81±0.08)nmoL/L vs(4.62±0.06)nmol/L(P<0.05)].and GSHPx declined at the end of the 3rd month(72.02±2.05)μmol/L vs(74.62±1.46)μmol/L(P<0.01)] Hemoglobin(Hb),and blood albumin (Alb) reduced without statistical significan (P>0.05);In group B and C.MDA declined more compared with Group A(3.86±0.06)nmol/L,(3.81±0.19)nmol/L vs (4.81±0.08)nmoL/L,(P<0.01)],while the GSHPx and NO increased significantly(92.11±1.62)μmol/L,(92.14±1.37)μmol/L vs(72.02±2.05)μmol/L;(64.24±1.72)μmol/L,(64.35±1.67)μmol/L vs (49.91±1.19)μmol/L(P<0.05)].In the 3rd month,Hb and Alb level rised obviously(P<0.05);Group D was better than Group B and C(P<0.01).Conclusions Levocamitine and Vitamin-E effectively improve oxidative stress and nutrition status and the function of endotllelial cells of the MHD patients.It probably slows atherosclerosis progress.Furthermore,the combined medication is better.