摘要
目的：研究静脉补充左旋卡尼汀对维持性血液透析患者肉碱缺乏症的治疗作用。方法：采用多中心、双盲、随机、对照的研究方法，选择血透患者１９７例，分为治疗组、对照组和开放组，治疗组和开放组静脉注射左旋卡尼汀１ｇ，２～３次／周×３月，对照组注射生理盐水。结果：治疗组和开放组体力、精神状态、食欲、恶心、呕吐、透析耐受性、透析中肌痉挛或低血压等症状的改善十分显著，血浆肉碱浓度明显升高，对照组以上各项均无变化，治疗组与对照组相比差异十分显著；治疗组及开放组血浆总蛋白、白蛋白、前白蛋白和转铁蛋白等营养参数也有不同程度的升高。主要不良反应为转氨酶轻度升高和血小板降低，发生率分别为５．３％和２．３％，停药后即可恢复正常。结论：左旋卡尼汀注射液治疗慢性肾衰维持血透患者肉碱缺乏症安全。
OBJECTIVE To investigate the near term effects of intravenous infusion of L carnitine in maintenance hemodialysis patients. METHODOLOGY It was a multicentered,double blinded and randomized clinical trial.One hundred and ninety seven patients on maintenance hemodialysis were included.They were randomly divided into three groups:treatment group( n =65),control( n =65)and open( n =67)groups.In treatment and open group,L canitine was given intravenously at the end of each dialysis treatment for 3 months,while normal saline was given in the control group.Serum free canitine level and relevant clinical/laboratory parameters were evaluated before the study and at the end of the first and the third month of the investigation. RESULTS The pre study plasm carnitine levels in the three groups were found of no significant differerce.Plasm carnitine levels in the treatment and open groups were significantly increased after treatment.Significant improvement of physical and mental status,nausea and vomiting,dialysis tolerance,intro dialysis hypotension and muscle cramps were observed in carnitine treated groups as compared to the placebo group.Plasm albumin,pro albumin,and transferin levels were also elevated in the treated groups. CONCLUSION Intravenous supplement of L carnitine in hemodialysis patients is associated with improved clinical status,sense of well being and certain serum nutritional indexes.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1998年第6期538-543,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
