左卡尼汀联合复方α-酮酸治疗对终末期肾病MHD患者营养状态和血清炎症因子水平的影响  

Effects of levocarnitine combined with compoundα-ketonic acid on nutritional status and serum inflammatory factors in MHD patients with end-stage renal disease

作　　者：李丹 宋海宁[1] 秦小莉 李震[1] 付坤 LI Dan;SONG Haining;QIN Xiaoli;LI Zhen;FU Kun(Department of Pharmacy,Chengdu Third People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院药学部,四川成都610000

出　　处：《西部医学》2025年第4期570-573,共4页Medical Journal of West China

摘　　要：目的探讨左卡尼汀联合复方α-酮酸应用于终末期肾病(ESRD)维持性血液透析(MHD)患者的临床疗效。方法选取2020年12月—2022年12月我院收治的104例行MHD的ESRD患者为观察对象,随机分为对照组和治疗组,每组52例。两组均行MHD治疗,在此基础上,对照组予以复方α-酮酸治疗,治疗组予以左卡尼汀联合复方α-酮酸治疗。比较两组患者治疗前后营养状态[白蛋白(ALB)、前白蛋白(PA)及血红蛋白(HGB)],炎症因子水平(IL-6和hs-CRP),氧化应激指标[丙二醛(MDA)和超氧化物歧化酶(SOD)],心功能[左心室舒张末期内径(LVEDD)和左心室射血分数(LVEF)],以及治疗期间安全性情况。结果治疗后,两组ALB、PA及HGB水平均升高,且与对照组比较,治疗组更高(P<0.05);治疗后,两组IL-6和hs-CRP水平均下降,且与对照组比较,治疗组更低(P<0.05);治疗后,两组MDA水平均下降,SOD水平均升高,且与对照组比较,治疗组更优(P<0.05);治疗后,两组LEVDD均下降,LVEF均升高,且与对照组比较,治疗组更优(P<0.05);治疗期间,两组安全性情况比较比较无明显差异(P>0.05)。结论左卡尼汀联合复方α-酮酸治疗行MHD的ESRD患者,可以纠正营养不良状态,抑制炎症因子水平和氧化应激反应,改善心功能,且安全性好。Objective To explore the clinical curative effect of levocarnitine combined with compoundα-ketonic acid on patients with end-stage renal disease(ESRD)after maintenance hemodialysis(MHD).Methods A total of 104 patients with ESRD undergoing MHD in the hospital were enrolled as the research objects from December 2020 to December 2022,and they were randomly divided into control group(52 cases,α-ketonic acid)and treatment group(52 cases,levocarnitine).The nutritional indexes[albumin(ALB),prealbumin(PA),hemoglobin(HGB)],inflammatory factors[interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP)],oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)]and cardiac function indexes[end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular]before and after treatment,and safety during treatment in the two groups were compared.Results After treatment,levels of ALB,PA and HGB were increased in both groups,which were higher in treatment group than control group(P<0.05).After treatment,levels of IL-6 and hs-CRP in both groups were decreased,which were lower in treatment group than control group(P<0.05).After treatment,MDA was decreased,while SOD was increased in both groups,and the two indexes were better in treatment group than control group(P<0.05).After treatment,LEVDD decreased and LVEF increased in both groups,and compared with control group,the treatment group was better(P<0.05).During treatment,there was no significant difference in safety between the two groups(P>0.05).Conclusion Levocarnitine combined with compoundα-ketonic acid can improve malnutrition,inhibit inflammatory factors and oxidative stress response,and improve cardiac function in ESRD patients undergoing MHD,with good safety.

关 键 词：左卡尼汀 复方Α-酮酸 终末期肾病 维持性血液透析 营养状态 炎症因子 

分 类 号：R692.5[医药卫生—泌尿科学]