左卡尼汀对维持性血液透析患者贫血状况、T淋巴细胞亚群和微炎症状态的影响  

Effect of L-carnitine on anemia,T lymphocyte subsets and microinflammation in maintenance hemodialysis patients

作　　者：范佳妮[1] 陈璐[1] 王颖 FAN Jia'ni;CHEN Lu;WANG Ying(Department of Nephrology,Enze Hospital,Taizhou Medical Center(Group)in Zhejiang Province,Taizhou 318050,China)

机构地区：[1]浙江省台州恩泽医疗中心(集团)恩泽医院肾内科,浙江台州318050

出　　处：《中国现代医生》2020年第21期123-126,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY882)。

摘　　要：目的探讨左卡尼汀对维持性血液透析(MHD)患者贫血状况、T淋巴细胞亚群和微炎症状态的影响。方法选择2015年1月~2018年12月接受MHD治疗的慢性肾功能衰竭患者80例,随机分为两组,各40例。两组均给予血液透析,观察组予以左卡尼汀针1.0 g加生理盐水20mL,对照组予以等量生理盐水,分别于每次透析结束时从透析通路静脉端推注。两组连用3个月。观察两组治疗前后贫血状况、T淋巴细胞亚群和微炎症指标变化。结果治疗3个月后,观察组Hb和Hct水平较前明显上升(P<0.05),而对照组变化不明显(P>0.05)。治疗后观察组Hb和Hct水平高于对照组(P<0.05);同时观察组CD4^+和CD4^+/CD8^+比值较前明显上升,CD8^+较前明显下降(P<0.05),而对照组变化不明显(P>0.05)。治疗后观察组CD4^+和CD4^+/CD8^+高于对照组,CD8^+低于对照组(P<0.05);同时观察组血清hs-CRP、IL-6和TNF-α较前明显下降(P<0.05),而对照组变化不明显(P>0.05)。治疗后观察组血清hs-CRP、IL-6和TNF-α水平低于对照组(P<0.05)。结论左卡尼汀不仅可提高Hb和Hct水平,改善MHD患者贫血状态,而且可纠正T细胞亚群紊乱及控制微炎症状态,增强细胞免疫功能。Objective To investigate the effect of L-carnitine on anemia,T lymphocyte subsets and microinflammation in maintenance hemodialysis(MHD)patients.Methods 80 patients with chronic renal failure who underwent MHD from January 2015 to December 2018 were randomly divided into two groups,with 40 cases in each group.Hemodialysis was given to the two groups.The observation group was given 1.0 g of L-carnitine needle and 20 mL of normal saline.The control group was given the same amount of normal saline.The medicine was injected from the venous end of the dialysis channel at the end of each dialysis.The two groups were used for 3 months.The changes of anemia,T lymphocyte subsets and microinflammation indexes before and after treatment were observed.Results After 3 months of treatment,the levels of Hb and Hct in the observation group were significantly higher than those before(P<0.05),but the change was not obvious in the control group(P>0.05).After treatment,the levels of Hb and Hct in the observation group were higher than those in the control group(P<0.05).At the same time,the ratio of CD4^+and CD4^+/CD8^+in the observation group was significantly higher than that in the previous group,and the CD8^+level was significantly lower than that before(P<0.05),while the change was not obvious in the control group(P>0.05).After treatment,the CD4^+and CD4^+/CD8^+in the observation group were higher than those in the control group,and the CD8^+was lower than that in the control group(P<0.05).At the same time,the serum hs-CRP,IL-6 and TNF-αin the observation group were significantly lower than those before(P<0.05).The change of the control group was not obvious(P>0.05).The serum levels of hs-CRP,IL-6 and TNF-αin the observation group were lower than those in the control group(P<0.05).Conclusion L-carnitine can not only improve the level of Hb and Hct,improve the anemia status of MHD patients,but also correct the disorder of T cell subsets and control the micro-inflammatory state and enhance the cellular immune function.

关 键 词：维持性血液透析 左卡尼汀 贫血 T淋巴细胞亚群 微炎症状态 

分 类 号：R692.5[医药卫生—泌尿科学]