左卡尼汀联合血液灌流对维持性血液透析患者微炎症状态的影响  

The effect of levocarnitine and hemoperfusion on micro-inflammatory state of maintenance hemodialysis patients

作　　者：郭齐[1] 

机构地区：[1]山东大学附属省立医院肾内科,济南250012

出　　处：《中国综合临床》2014年第6期606-609,共4页Clinical Medicine of China

摘　　要：目的：探讨左卡尼汀联合血液灌流对维持性血液透析患者微炎症状态的影响。方法将2006年1月至2013年1月于我院行血液透析的99例患者作为研究对象，据治疗方法的不同分为3组，其中33例应用血液灌流联合左卡尼汀治疗，设立为A组；33例应用血液灌流治疗，设立为B组；33例应用普通透析，设立为C组。比较3组患者用药前及用药后1、6个月超敏C反应蛋白（ hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）的变化情况。结果 A组患者血IL-6浓度治疗前及治疗后1、6个月分别为（77.53±12.64）、（62.17±11.09）、（42.76±10.22）ng/L，B组患者分别为（76.13±13.46）、（70.07±2.54）、（59.35±11.21）ng/L，C 组患者分别为（78.10±10.74）、（72.81±11.73）、（68.11±13.53）ng/L，F组内=11.642，P〈0.01；F组间=6.341，P〈0.01，F交互=18.275，P〈0.01；A组与B、C组同一时间段的比较，差异均有统计学意义（ P均〈0.05）。A组患者血TNF-α浓度治疗前及治疗后1、6个月分别为（43.59±9.81）、（32.34±8.68）、（25.7±71.27）ng/L，B组患者分别为（44.53±8.62）、（39.15±9.72）、（34.82±7.21）ng/L，C组患者分别为（42.19±6.72）、（38.63±7.65）、（36.98±5.89）ng/L， F组内=10.630、P〈0.01，F组间=6.654、P〈0.01，F交互=18.273、P〈0.01；A组与B、C组同一时间段的比较，差异均有统计学意义（P均〈0.05）。A组患者血hs-CRP浓度治疗前及治疗后1、6个月分别为（9.34±1.16）、（7.28±1.05）、（5.13±0.84）mg/L，B 组患者分别为（9.05±1.36）、（7.97±1.08）、（5.82±1.13）mg/L，C组患者分别为（9.25±1.34）、（8.83±1.12）、（8.56±1.08）mg/L，F组内=12.002、P〈0.01，F组间=6.681、P〈0.01，F交互=17.753、P〈0.01；A组与B、C组同一时间段的比较，差异均有统计学意义（ P均〈0.05）。结论左卡尼汀可以有效治疗维持性血液透析患者微炎症状态�Objective To investigate the effect of levocarnitine ane hemoperfusion on micro-inflammatory state of maintenance hemoeialysis patients. Methods Ninety-nine hemoeialysis patients were selectee as our subjects who hospitalizee from Jan. 2006 to Jan. 2013 in Provincial Hospital Affiliatee to Shaneong University ane were raneomly eivieee into A,B ane C groups. Thirty-three patients in A group were treatee with hemoperfusion combinee with L-carnitine therapy,33 cases in B group were appliee hemoperfusion ane 30 cases in C group were treatee with oreinary eialysis. The level of high sensitivity C reactionprotein（ hs-CRP）,interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）were measuree at before treatment,1ane 6 months after treatment. Results The levels of IL-6 in A group at before treatment,1 ane 6 months were（（ 77. 53 ±12. 64）,（62. 17 ± 11. 09）,（42. 76 ± 10. 22））ng/L respectively,ane those were（（76. 13 ± 13. 46）, （70. 07 ± 2. 54）,（59. 35 ± 11. 21））ng/L respectively in B group ane（（78. 10 ± 10. 74）,（72. 81 ± 11. 73）, （68. 11 ± 13. 53））ng/L respectively in C group. The eifferences were significant（ F within group=11. 642,P〈0. 01;F among groups=6. 341,P〈0. 01,F interaction=18. 275,P〈0. 01）,ane at the same perioe,there was significant eifference between A ane B,C group（ P 〈0. 05 ）. The levels of TNF-α in A group at before treatment,1 ane 6 months were（（43. 59 ± 9. 81）,（32. 34 ± 8. 68）,（25. 7 ± 71. 27））ng/L respectively,ane those were（（44. 53 ± 8. 62）,（39. 15 ± 9. 72）,（34. 82 ± 7. 21））ng/L respectively in B group ane（（42. 19 ± 6. 72）,（38. 63 ± 7. 65）,（36. 98 ± 5. 89））ng/L respectively in C group. The eifferences among 3 groups were significant（ F within groups = 10. 630,P 〈 0. 01;F among groups = 6. 654,P 〈 0. 01;F interaction=18. 273,P〈0. 01）,ane at the same perioe,there was significant eifference between A ane B,C group（ P〈0. 05）. The levels of hs-CRP in A group

关 键 词：左卡尼汀 血液灌流 维持性血液透析 微炎症状态 

分 类 号：R459.5[医药卫生—治疗学]