摘要
目的观察静脉应用左旋肉碱(可益能)对腹膜透析病人血浆肉碱水平、血红蛋白水平及肌力的影响。方法选择有明显疲乏无力、肌肉酸痛症状伴或不伴贫血的慢性腹膜透析患者38例为实验组,同时选取29例无肌肉症状伴或不伴贫血的慢性腹膜透析患者作为对照组,观察两组患者血浆肉碱水平情况,静脉给予可益能15mg/kg,隔日1次,应用24周后,血红蛋白水平及肌力的改善情况。结果实验组血浆游离肉碱(FC)水平明显低于对照组,而酯酰肉碱(AC)与游离肉碱比值则相反;给予可益能静脉注射24周后,实验组血浆总肉碱(TC)、FC、AC较治疗前增加,AC/FC值下降,患者肌肉酸痛症状得到改善,上肢握力增加,贫血者血红蛋白(Hb)水平增高,促红素(rHuEPO)用量减少;静脉应用可益能对腹膜透析患者脂代谢无影响。结论给予可益能静脉应用可以纠正腹膜透析患者肉碱缺乏所引起的相关症状,改善贫血,增加患者肌力,且无明显不良反应。
Objective To study the effect of carnitine supplementation on plasma carnitine fractions,heamoglobin levels and muscle strength in peritoneal dialysis patients.Methods 38 peritoneal dialysis patients with muscular weakness,fatigue,or cramps/aches,and anemia or not were included,also randomly selecting 29 peritoneal dialysis patients who were completely free of muscular symptoms,and anemia or not.Compared with plasma carnitine leves between those two groups,patients with muscular symptoms were given a dose of 15 mg/kg intravenous injection every other day for 24 weeks.Then,assess whether L-carnitine treatment was sufficient to alleviate peritoneal dialysis patients＇muscular symptoms and to understand how carnitine affectsed the Hb in anemia patients.Results Plasma free carnitine（FC）of patients who had muscular weakness and fatigue,was lower than those free of muscular symptoms,Acyl carnitine and free carnitine ratio （AC/FC）were opposite.After 24 weeks of L-carnitine supplementation plasma FC,AC,and total carnitine （TC）had increased,conversely,AC/FC ratio were decreased.Almost all petients treated with L-carnitine had improvement in muscular symptoms,muscular power were strengthened.At the end of study,in carnitine patients who had anemia the heamoglobin levels were increased and the dose of recombinant human erythropoietin（rHuEPO） were strongly reduced.After 24 weeks of L-carnitine supplementation,lipid metablism showed no demonstrable changes.Conclusion L-carnitine supplementation can alleviate dialysis-associated muscular symptoms,strengthen muscle strength and increase heamoglobin levels,reduce the rHuEPO requirement,with preventing negative lipid effects.
出处
《河南科技大学学报（医学版）》
2009年第4期258-260,共3页
Journal of Henan University of Science & Technology:Medical Science
关键词
左旋肉碱
腹膜透析
贫血
促红素
握力
L-carnitine
peritoneal
dialysis
anemia
rHuEPO
handgrip strength
