左卡尼汀辅助治疗对血液透析患者EPO抵抗和氧化应激及炎症反应的影响  

Effect of adjuvant levocarnitine therapy on EPO resistance,oxidative stress response and inflammatory response in patients with hemodialysis

作　　者：侯丹丹[1] 王淑领 尚赛男[1] 

机构地区：[1]北京市朝阳区双桥医院血液净化中心,北京100101

出　　处：《海南医学院学报》2017年第15期2056-2059,2063,共5页Journal of Hainan Medical University

基　　金：中华医学会临床医学科研项目(12020360176)

摘　　要：目的:研究左卡尼汀辅助治疗对血液透析患者内源性促红细胞生成素(EPO)抵抗和氧化应激及炎症反应的影响。方法:选择2015年5月~2016年10月期间在北京市朝阳区双桥医院接受维持性血液透析的78例患者,随机分为两组,左卡尼组接受左卡尼汀联合常规纠正贫血的治疗,对照组接受常规纠正贫血的治疗。治疗前及治疗后3、6个月时,评估两组患者的EPO抵抗程度、氧化应激反应程度、炎症反应程度。结果:治疗后3、6个月时,左卡尼汀组患者重组人促红细胞生成素(rhuEPO)用量及促红细胞生成素反应指数(erythropoietin response index,ERI)、外周血单个核细胞中Nrf-2、ARE、HO-1、NQO-1的表达量以及血清中晚期氧化蛋白产物(AOPP)、8-OHdG、丙二醛(MDA)、单核细胞趋化蛋白(MCP-1)、可溶性细胞间黏附分子(sICAM-1)、PTX3、白介素(IL)-4、IL-10的含量呈逐步降低趋势,对照组患者rhuEPO用量及ERI指数、外周血单个核细胞中Nrf-2、ARE、HO-1、NQO-1的表达量以及血清中AOPP、8-OHdG、MDA、MCP-1、sICAM-1、PTX3、IL-4、IL-10的含量无显著变化。结论:左卡尼汀辅助治疗对血液透析患者EPO抵抗、氧化应激反应、炎症反应均具有显著的改善作用。Objective： To study the effect of adiuvant levocarnitine therapy on EPO resistance, oxidative stress response and inflammatory response in patients with hemodialysis. Methods： A total of 78 patients who received maintenance hemodialy- sis in Beijing Chaoyang District Shuangqiao Hospital between May 2015 and October 2016 were selected and randomly divided into two groups： the levocarnitine group received levocarnitine combined with conventional anemia correction therapy, and the control group accepted routine anemia correction therapy. The extent of EPO resistance, oxidative stress response and inflam- matory response in two groups of patients were assessed before treatment as well as 3 months and 6 months after treatment. Results= Three months and six months after treatment, the rhuEPO dosage and ERI, Nrf-2, ARE, HO-1 and NQO-1 expres- sion in peripheral blood mononuelear cells as well as AOPP, 8-OHdG, MDA, MCP-1, sICAM-1, PTX3, IL 4 and IL-10 levels in serum of levocarnitine group had been gradually decreasing while the rhuEPO dosage and ERI, Nrf-2, ARE, HO-1 and NQO-1 expression in peripheral blood mononuclear cells as well as AOPP, 8-OHdG, MDA, MCP-1, sICAM-1, PTX3, IL-4 and IL-10 levels in serum of control group were without significant change. Oonclusion~ Adjuvant levocarnitine therapy can sig- nificantly improve the EPO resistance, oxidative stress response and inflammatory response in patients with hemodialysis.

关 键 词：血液透析 左卡尼汀 促红细胞生成素抵抗 氧化应激反应 炎症反应 

分 类 号：R459.5[医药卫生—治疗学]