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目的:观察左卡尼汀对维持性血液透析患者微炎症状态的影响及疗效。方法:慢性肾功能衰竭维持性血液透析患者80例,采用随机数字表法分为观察组和对照组各40例。两组患者均以血液透析治疗,透析频率和时间相同(3次/周,4 h/次)。观察组患者加用左卡尼汀注射液1.0 g+0.9%氯化钠注射液20 ml,透析后缓慢静注,连用8周。观察两组患者治疗前后血浆白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平变化,比较两组治疗前后症状体征评分变化及药品不良反应。结果:治疗8周后,观察组患者血浆IL-1β、IL-6、TNF-α水平明显降低(P<0.05),且明显低于对照组(P<0.05);而对照组患者治疗前后无明显变化(P>0.05)。观察组患者症状体征评分较治疗前明显下降(P<0.05),且明显低于对照组(P<0.05);而对照组患者治疗前后无明显变化(P>0.05)。两组患者治疗期间均未发生明显药品不良反应。结论:左卡尼汀用于维持性血液透析患者具有良好的疗效,安全性好,能降低维持性血液透析患者血浆IL-1β、IL-6、TNF-α水平,改善患者的微炎症状态。
Objective: To observe the effect of levocarnitine on micro-inflammatory status in patients with maintenance hemodialysis and its curative effect. Methods: Eighty patients with maintenance hemodialysis of chronic renal failure were randomly divided into observation group and control group with 40 cases in each group. Both groups were treated with hemodialysis, with the same dialysis frequency and time (3 times / week, 4 h / time). Patients in the observation group were treated with levocarnitine injection 1.0 g + 0.9% sodium chloride injection 20 ml, intravenously slowly after dialysis for 8 weeks. The changes of plasma IL-1β, IL-6 and TNF-α levels before and after treatment were observed before and after treatment. The scores of symptoms and signs before and after treatment were compared between the two groups Changes and adverse drug reactions. Results: After 8 weeks of treatment, the levels of IL-1β, IL-6 and TNF-α in the observation group decreased significantly (P <0.05), and were significantly lower than those in the control group (P <0.05) Significant changes (P> 0.05). The symptom and symptom scores of observation group were significantly lower than those before treatment (P <0.05), and were significantly lower than those of control group (P <0.05); while those of control group showed no significant changes before and after treatment (P> 0.05). Two groups of patients during treatment did not occur obvious adverse drug reactions. CONCLUSION: L-carnitine is effective in maintenance hemodialysis patients and has good safety. It can reduce the levels of IL-1β, IL-6 and TNF-α in maintenance hemodialysis patients and improve the micro-inflammatory status of patients.