左-卡尼汀对维持性血液透析患者急性时相蛋白合成的影响  

Effects of Levo-Carnitine on Acute-Phase Protein Synthesis in Maintenance Hemodialysis Patients

作　　者：苏海华[1,2] 姜埃利[1] 魏芳[1] 陈海燕[1] 孙桂江[1] 王立华[1] 

机构地区：[1]天津医科大学第二医院血液净化中心,300211 [2]海洋石油总医院肾内科

出　　处：《天津医药》2009年第3期192-195,共4页Tianjin Medical Journal

摘　　要：目的:探讨左-卡尼汀在调节维持性血液透析患者急性时相蛋白合成中的作用。方法:选择132例维持性血液透析患者,随机分为LC组66例和对照组66例。治疗前和治疗3个月后测定超敏C反应蛋白(hs-CRP)、改良主观全面营养评价法营养不良评分(MS)、体质量指数(BMI)、标准化蛋白分解代谢率(nPCR)以及血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(Tf)、血红蛋白(Hb)、肌酐(SCr)、尿素氮(BUN)、钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)等生化指标。结果:2组治疗前各项指标比较差别无统计学意义(P>0.05)。3个月后LC组hs-CRP、MS水平较治疗前明显降低(P<0.01),血清Alb、PA、Tf、Hb、BMI和nPCR水平较治疗前提高(P<0.01或P<0.05),对照组Hb、PA较前提高P<0.05)。治疗3个月后LC组hs-CRP、MS低于对照组(P<0.01),血清Alb、PA、Tf、BMI和nPCR高于对照组(P<0.05)。结论:左-卡尼汀通过抑制正性时相蛋白合成,促进负性时相蛋白合成有效调节维持性血液透析患者的急性时相反应,从而改善患者的微炎症状态和营养状况。Objective： To explore the effects of Levo-carnitine （L-carnitine） on acute-phase protein synthesis in maintenance hemodialysis （MHD） patients. Methods： One hundred and thirty-two patients with MHD were randomly divided into two groups which included LC group （1 g L-carnitine intravenously and three times per week） and control group n = 66 for each group. The high-sensitivity C-reactive protein （hs-CRP）, malnutrition score （MS, assessing the value of modified quantitative subjective global assessment of nutrition）, body mass index （BMI, ratio of weight to square of height）, nor-malized protein catabolic rate （nPCR）, and some biochemical parameters including serum albumin （Alb）, prealbumin （PA）, hemoglobin （Hb）, transferrin （TO, creatinine （Cr）, urea nitrogen （BUN）, calcium （Ca）, phosphorus （P） and intact parathormone （iPTH） were detected before and three months after treatment. Results： There were no significant differences in all parameters before treatment between LC group and control group.The hs-CRP and MS were significantly decreased and the mean values of serum Alb, PA, Tf, Hb, BMI and nPCR were increased three months after treatment in LC group （P 〈 0.01 or P 〈 0.05）. There were no significant differences in serum BUN, Cr, Ca, P and iPTH before and after treatment in two groups（P 〉 0.05）. The levels of Hb and PA were increased three months after treatment in control group （P 〈 0.01 or P 〈 0.05）. There were no significant differences in other indexes before and after treatment in control group （P 〉 0.05）. The levels of Hs-CRP and MS were significantly lower three months after treatment in LC group than those in control group （P 〈 0.05）. The mean values of serum Alb, PA, Tf, BMI and nPCR were higher in LC group compared with those of control group （P 〈 0.05）. There were no significant differences in other biochemical indicators including Hb, BUN, Cr, Ca, P and iPTH in two groups （P 〉 0.05）. Conclu

关 键 词：肉碱 急相蛋白质类 肾疾病 肾透析 炎症 营养 

分 类 号：R459.5[医药卫生—治疗学] R392.11[医药卫生—临床医学]