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目的:探讨厄贝沙坦和左卡尼汀对维持性血液透析(MHD)患者炎症因子和营养指标的改善作用。方法:选择2013年1月至2014年6月在我院血液透析中心接受MHD的终末期肾脏病患者120例为研究对象,依据随机数字表分成单纯透析组、厄贝沙坦组、左卡尼汀组和联合用药组,各30例,分别接受单纯透析治疗,口服厄贝沙坦0.15-0.3g/d,静脉推注左卡尼汀1g/次,厄贝沙坦和左卡尼汀联合治疗。检测治疗前,治疗3、6个月后血清中C反应蛋白(CRP)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)转化生长因子(TGF)水平及营养状况指标的变化。结果:治疗3个月后,厄贝沙坦组、左卡尼汀组及联合用药组CRP、IL-8和TGF的水平与治疗前及单纯透析组比较均有明显下降(P<0.05),治疗6个月后,厄贝沙坦组、左卡尼汀组及联合用药组CRP、IL-8、IL-10和TGF水平较治疗前及纯透析组均明显下降(P<0.05),且联合用药组下降程度显著高于厄贝沙坦组和左卡尼汀组(P<0.05)。治疗6个月后,左卡尼汀组及联合用药组血清红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PA)水平较治疗前及单纯透析组显著升高(P<0.05),联合用药组血清Hb、Alb和PA水平上升更明显,差异均有统计学意义(P<0.05)。结论:厄贝沙坦联合左卡尼汀既能缓解MHD患者的微炎症反应,又能改善其营养状况。
Objective: To investigate the effect of irbesartan and levocarnitine on the improvement of inflammatory factors and nutrition in maintenance hemodialysis (MHD) patients. Methods: From January 2013 to June 2014, 120 patients with end-stage renal disease receiving MHD from our hemodialysis center in our hospital were enrolled. According to the random number table, we divided them into dialysis group, irbesartan group, The combination group and the combination group, each 30 cases, were treated with dialysis alone, oral irbesartan 0.15-0.3g / d, intravenous injection of levocarnitine 1g / times, irbesartan and levocarnitine treatment. Serum C-reactive protein (CRP), interleukin-8 (IL-8), interleukin-10 (IL-10) and transforming growth factor (TGF) levels were measured before and 3 and 6 months after treatment. Changes in status indicators. Results: The levels of CRP, IL-8 and TGF in irbesartan group, levocarnitine group and combination group were significantly decreased compared with those before treatment and dialysis group (P <0.05) after 3 months treatment, The levels of CRP, IL-8, IL-10 and TGF in irbesartan group, levocarnitine group and combination group were significantly lower than those before treatment and in pure dialysis group after 6 months of treatment (P <0.05), and The combination group decreased significantly more than irbesartan group and levocarnitine group (P <0.05). After 6 months of treatment, the serum levels of Hb, Alb and PA in L-carnitine group and combination group were significantly higher than those before treatment and in dialysis group (P <0.05 ). The levels of serum Hb, Alb and PA increased more significantly in the combination group, with statistical significance (P <0.05). Conclusion: Irbesartan combined with levocarnitine can alleviate the microinflammatory response of MHD patients and improve their nutritional status.