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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

21

期数:

2020年04期

页码:

514-516

栏目:

论　著

出版日期:

2020-04-28

文章信息/Info

Title:

Effects of L-carnitine combined with high-flux hemodialysis on inflammatory factors and cardiac function in maintenance hemodialysis patients

作者:

王春花; 李超; 朱莺; 高磊平; 周育锋

常熟市中医院肾内科，江苏 常熟 215500

Author(s):

WANGChun-hua; LIChao; ZHUYing; GAOLei-ping; ZHOUYu-feng

Department of Nephrology,Changshu Chinese MedicineHospital,Changshu215500,Jiangsu,China Correspondingauthor:WANGChun-hua,E-mail:xqyylbq@163.com

关键词:

高通量透析; 左卡尼汀; 维持性血液透析; 微炎症状态; 心脏功能

Keywords:

L-carnitine;  High-flux hemodialysis;  Maintenance hemodialysis;  Micro inflammatory state;  Cardiac function

分类号:

R459.5

DOI:

-

摘要:

目的 探讨左卡尼汀联合高通量透析对维持性血液透析患者炎症因子及心脏功能的影响。方法 选择常 熟市中医院维持性血液透析患者70例，随机分为观察组和对照组，每组35例。对照组患者采用高通量透析器进 行维持性血液透析，基础治疗包括控制血压、血糖、改善贫血及纠正钙磷代谢等；观察组在对照组基础上，于每 次透析结束后直接推注左卡尼汀1 g。两组患者均连续治疗3个月。观察两组治疗前后C反应蛋白（CRP）、白细 胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）等炎症因子的变化；观察两组治疗前后脑钠肽（BNP）水平、心 排血量（CO）、左心室射血分数（LVEF）等心脏功能指标的变化。结果 治疗后，观察组CRP、IL-6、 TNF-α、BNP水平均较治疗前明显降低，CO、LVEF较治疗前明显上升，差异均有统计学意义（P<0.05）；且 观察组治疗后CRP、TNF-α 水平低于对照组，CO高于对照组，差异有统计学意义（P<0.05）。两组患者治疗 过程中均未见明显不良反应。结论 左卡尼汀联合高通量透析能够有效缓解维持性血液透析患者的微炎症状 态，对心脏功能也有一定的保护作用，且无明显不良反应。

Abstract:

Objective To investigate the effects of L-carnitine combined with high-flux hemodialysis on inflammatory factors and cardiac function in maintenance hemodialysis patients. Methods Seventy patients with maintenance hemodialysis in Changshu Chinese Medicine Hospital were selected and ran-domly divided into the observation group and the control group, and each group had 35 patients. The patients in the control group were treated with maintenance hemodialysis and basic treatment such as blood pressure control, blood sugar control, anemia correction and improvement of calcium and phos-phorus metabolism. On the basis of the control group, patients in the observation group were directly injected 1 g L-carnitine after each dialysis. Both groups were treated for 3 months. The changes of in-flammatory factors including C-reactive protein（CRP）, interleukin-6（IL-6）, tumor necrosis factor α（TNF-α）and cardiac function indexes including B-type natriuretic peptide（BNP）, cardiac output （CO）, left ventricular ejection fraction（LVEF）were observed before and after treatment in the two groups. Results After treatment, the levels of CRP, IL-6, TNF-α, and BNP in the observation group were significantly decreased, while the levels of CO and LVEF were significantly increased, the differences were statistically significant（P<0.05）. There were significant differences in the levels of CRP, TNF-α and CO between the two groups（P<0.05）. No obvious adverse reactions were ob-served during the treatment of the two groups. Conclusion L-carnitine combined with high-flux he-modialysis can effectively alleviate the micro-inflammatory state of the patients on maintenance hemo-dialysis, and also can protect the cardiac function without obvious adverse reactions.

参考文献/References:

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备注/Memo

备注/Memo:

作者简介：王春花，硕士研究生，副主任医师，研究方向：终末期肾病 通信作者：王春花，E-mail：xqyylbq@163.com

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更新日期/Last Update: 2020-04-28