左卡尼汀对维持性血液透析患者微炎症状态及相关炎症因子的影响

摘要

目的 探讨静脉注射左卡尼汀对维持性血液透析(maintenance hemodialysis,MHD)患者微炎症状态及相关炎症因子的影响.方法 选择透析中心透析龄>12个月的MHD患者68例,随机分为治疗组35例,对照组33例.两组常规治疗相同,治疗组于每次透析结束后给予静脉注射左卡尼汀1 g,治疗3个月,分别检测治疗前及治疗1,3个月末患者的血生化指标、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6、IL-8、肿瘤坏死因子α(TNF-α)、脂蛋白(a)[Lp(a)]、透析充分性(Kt/V).结果 治疗组1个月后hs-CRP、IL-6、IL-8、TNF-α、Lp(a)平均值较治疗前下降,治疗组与对照组比较差异有统计学意义(均P＜0.05).3个月后治疗组hs-CRP、IL-6、IL-8、TNF-a、Lp(a)平均值较治疗前明显下降,与对照组比较差异有统计学意义(均P＜0.01).结论 左卡尼汀可以降低维持性血液透析患者hs.CRP、IL-6、IL-8、TNF-α、Lp(a)浓度,并改善微炎症状态.%Objective To study the effects of levocarnitine by intravenous injection on microinflammatory state and correlation inflammatory factor in maintenance hemodialysis patients. Methods Sixty-eight maintenance hemodialysis (＞ 12 months) patients in our dialysis center were enrolled, and were randomly divided into treatment group and control group. Patients in the treatment group were injected with levocarnitine ( 1.0 g once) after every dialysis for 3 months,while patients in the control group only accepted routine hemodialysis therapy. Blood biochemical indicators, serum hs-CRP, IL-6, IL-8, TNF-α,Lp(a) and Kt/V value were measured and compared at the experiment onset, 1 month and 3 months later. Results The hs-CRP, IL-6, IL-8, TNF-α and Lp ( a) level were obviously decreased in the treatment group after 1 month, and there were significantly difference between two groups( P＜0. 05 ). All above markers in the treated group were descended further after 3 months, and the difference between two groups was more significant( P＜0.01). Conclusion Levocarnitine can reduce serum level of hs-CRP, IL-6,IL-8, TNF-α and Lp(a) and improve the microinflammatory state in maintenance hemodialysis patients.