左卡尼汀对糖尿病肾病透析病人炎性因子与红细胞免疫的影响  

Effect of L-carnitine on inflammatory factors and RBC immunity in diabetic nephropathy patients treated with dialysis

作　　者：苏真 陈建梅[2] 

机构地区：[1]北京市仁和医院内科,102600 [2]解放军总医院第一附属医院心内科,北京100048

出　　处：《蚌埠医学院学报》2017年第10期1349-1352,共4页Journal of Bengbu Medical College

基　　金：解放军总医院科技创新苗圃基金项目(14KMM26)

摘　　要：目的:观察静脉推注左卡尼汀对糖尿病肾病(DN)维持性血液透析(MHD)病人炎性因子与红细胞免疫功能的影响。方法:将89例MHD病人随机分为观察组(47例)和对照组(42例),2组均给予血液透析治疗,每周2~3次,每次4 h,观察组在每次透析结束前5 min静脉推注左卡尼丁注射液,每次1 g,治疗1个月、3个月后,2组采外周血检测炎性因子与红细胞免疫指标。结果:伴随治疗时间延长,观察组白细胞介素-6、肿瘤坏死因子-α、高敏-C反应蛋白逐步下降,对照组下降不明显;观察组治疗1个月、3个月后上述炎性因子水平显著低于对照组(P<0.01)。2组病人治疗后红细胞C3b受体花环百分比、CD35阳性RBC百分比、超氧化物歧化物水平逐步上升,红细胞免疫复合物花环百分比逐步下降;观察组治疗1个月、3个月后红细胞C3b受体花环百分比、CD35阳性RBC高于对照组(P<0.05~P<0.01),而治疗1个月、3个月后红细胞免疫复合物花环百分比则显著低于对照组(P<0.01)。结论:对MHD治疗的DN病人补充外源性左卡尼汀可明显改善病人微炎性反应状态,同时能提高红细胞免疫功能。ObjectiveTo observe the effects of L-carnitine injection on inflammation and red blood cell（RBC） immune function indiabetic nephropathy（DN） patients treated with maintenance hemodialysis（MHD）. Methods：Eighty-nine MHD patients were randomlyinto the observation group（47 cases） and control group（42 cases）. Two groups were treated with peritoneal dialysis,2 to 3 times aweek,4 h each time. The observation group was intravenously injected with L-carnitine for 5 min before the end of the dialysis,1 g eachtime. The inflammatory factors and RBC immune indexes in two groups were detected after 1 and 3 months of treatment. Results：Withthe prolonging of treatment,the levels of IL-6,TNF-α,and hs-CRP in observation group declined gradually,and the decreasing degree ofthose in control group was not obvious. The levels of inflammatory factors in observation group after 1 month and 3 months of treatmentwere significantly lower than those in control group（P 〈 0. 01）. After treatment,the percentages of RBC-C3bRR wreath and CD35positive RBC,and level of SOD gradually increased,and the percentage of RBC-ICR wreath declined gradually in two groups. After 1month and 3 months of treatment,the percentages of RBC-C3bRR wreath and CD35 positive RBC in observation group were significantlyhigher than those in control group（P 〈 0. 05 to P 〈 0. 01）,but the percentage of RBC-ICR wreath in observation group after 1 monthand 3 months of treatment was significantly lower than that in control group（P 〈 0. 01）. Conclusions：The exogenous L-carnitine in DNpatients treated with MHD can obviously improve micro-inflammation status,and erythrocyte immune function.[

关 键 词：糖尿病肾病 血液透析 左卡尼汀 炎性因子 红细胞免疫 

分 类 号：R692.39[医药卫生—泌尿科学]