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目的:探讨左卡尼汀辅助治疗对维持性血液透析(MHD)患者血清营养指标及炎症因子水平的影响。方法:62例MHD患者随机分为观察组与对照组各31例。观察组患者每次透析结束后给予左卡尼汀注射液1 g iv,对照组患者给予等容量0.9%氯化钠注射液iv,均治疗3个月。比较两组患者治疗前后血红蛋白(Hb)、白蛋白(Alb)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等营养指标及C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)等炎症因子水平变化。结果:治疗后,观察组血清Hb、Alb水平较治疗前明显提高(P<0.05),而血清TC、TG、HDL-C及LDL-C水平无明显变化(P>0.05);对照组各项指标治疗前后均无明显变化(P>0.05);观察组患者治疗后血清Hb、Alb水平明显高于对照组(P<0.05)。观察组患者血清CRP、IL-6、IL-8及TNF-α水平均较治疗前明显降低(P<0.05),而对照组各项指标治疗前后无明显变化(P>0.05);观察组治疗后各项指标均明显低于对照组(P<0.05)。结论:左卡尼汀辅助治疗MHD患者能明显改善患者营养状态及微炎症状态,且对机体血脂代谢不会造成明显影响,对降低并发症的发生,提高患者预后生活质量具有非常重要的价值,值得临床进一步推广应用。
Objective: To investigate the effects of levocarnitine adjuvant therapy on the serum nutrition index and the level of inflammatory cytokines in maintenance hemodialysis (MHD) patients. Methods: 62 patients with MHD were randomly divided into observation group and control group, 31 cases each. Patients in the observation group were given levocarnitine 1 g iv after each dialysis, while patients in the control group were given iv 0.9% sodium chloride iv iv for 3 months. The levels of Hb, Alb, TC, TG, LDL-C and HDL-C before and after treatment were compared between the two groups. ), And other inflammatory factors such as C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF- Results: After treatment, the levels of serum Hb and Alb in observation group were significantly higher than those before treatment (P <0.05), while the levels of TC, TG, HDL-C and LDL-C in serum did not change significantly There was no significant change in index before and after treatment (P> 0.05). Serum Hb and Alb levels in observation group were significantly higher than those in control group (P <0.05). The levels of serum CRP, IL-6, IL-8 and TNF-α in the observation group were significantly lower than those before treatment (P <0.05), while those in the control group showed no significant changes before and after treatment (P> 0.05) After the indicators were significantly lower than the control group (P <0.05). CONCLUSION: L-carnitine adjuvant therapy for patients with MHD can significantly improve the nutritional status and micro-inflammatory status of patients with no significant effect on the metabolism of blood lipids, which is of great value in reducing the incidence of complications and improving the prognosis of patients with quality of life. Worth further clinical application.