左旋卡尼汀在维持性血液透析患者中的应用

目的探讨静脉补充左旋卡尼汀对慢性肾衰竭维持性血液透析患者肉碱缺乏症的治疗效果并评价其药物不良反应。方法将78例维持性血液透析患者随机分为治疗组和对照组。治疗组患者在血液透析结束后接受左旋卡尼汀1.0 g,静脉注射,每周2~3次,疗程12周。对照组注射生理盐水。结果静脉注射左旋卡尼汀可显著提高维持性血液透析肉碱缺乏患者的血浆游离肉碱水平(P<0.01);治疗组患者精神状态、食欲、透析中肌痉挛和低血压等症状的改善率明显高于对照组(P<0.01);与对照组比较,疗程结束后治疗组患者血红蛋白、血浆总蛋白、白蛋白和转铁蛋白升高更为显著(P<0.05)。结论维持性血液透析患者静脉补充左旋卡尼汀可明显改善患者的营养不良状况,纠正贫血,降低透析中肌痉挛和低血压的发生率;不良反应轻微,安全可靠。

Clinical use of L-carnitine supplementation in maintenance hemodialysis patients

Objective To investigate the clinical effects of L-carnitine supplementation in maintenance hemodialysis patients with L-carnitine deficiency.Methods 78 maintenance hemodialysis patients were randomly divided into control and treatment groups.They received placebo or L-carnitine intravenously which was injected in a dose of 2.0-3.0g per week for 12 weeks after hemodialysis.Results Intravenous treatment of L-carnitine significantly increased plasma free carnitine level of patients(P<0.01);Compared with control group,the L-carnitine-treated group showed a statistically significant decrease in fatigue,lethargy,muscular weakness,dialysis-related hypotension and recurrent cramps(P<0.01) and increase in blood hemoglobin,serum total protein,albumin and transferrin(P<0.05).Conclusion Intravenous L-carnitine supplementation to maintenance hemodialysis patients safely and effectively improves protein-energy malnutrition,ameliorates anaemia,and decreases the incidence of dialysis-related hypotension and recurrent cramps.Side effects of Intravenous L-carnitine supplementation are slight.