透析前注射左卡尼汀对糖尿病肾病患者蛋白质能量消耗及骨代谢的影响

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摘要目的探讨糖尿病肾病血液透析患者透析前应用左卡尼汀对其蛋白质能量消耗（PEW）以及骨代谢的影响。方法回顾性分析2016年10月～2018年10月辽宁省健康产业集团铁煤总医院收治的70例糖尿病肾病行血液透析患者的临床资料，根据透析前是否应用左卡尼汀，将其分为观察组和对照组，每组各35例。两组患者均接受高通量透析治疗，对照组患者不使用左卡尼汀，观察组患者在每次透析前15 min 给予左卡尼汀注射液1.0 g。比较两组患者治疗前后的PEW 相关指标及骨代谢指标。结果观察组患者治疗后的前白蛋白（PA）、白蛋白（ALB）、胆固醇以及瘦体重高于治疗前，C-反应蛋白（CRP）、低密度脂蛋白胆固醇（LDL-C）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）水平低于治疗前，差异有统计学意义（P＜0.05）；观察组患者治疗后的血红蛋白水平与治疗前比较，差异无统计学意义（P＞0.05）。对照组患者治疗后的TG水平低于治疗前，差异有统计学意义（P＜0.05）。治疗后，观察组患者的PA、瘦体重、ALB 水平高于对照组，CRP、LDL-C水平低于对照组，差异有统计学意义（P＜0.05）；治疗后，两组患者的血红蛋白、胆固醇、HDL-C以及TG水平比较，差异无统计学意义（P＞0.05）。治疗后，观察组患者的甲状旁腺激素水平低于对照组，25-羟基维生素D3水平高于对照组，差异有统计学意义（P＜0.05）。结论糖尿病肾病血液透析患者透析前应用左卡尼汀可以改善PEW、骨代谢紊乱，适合在临床上推广应用。

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	吴娱
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关键词 ：左卡尼汀, 糖尿病肾病, 透析, 蛋白质能量消耗, 骨代谢

Abstract：Objective To investigate the effect of the application of Levocarnitine on protein energy expenditure (PEW)and bone metabolism of patients with diabetic nephropathy hemodialysis before dialysis.Methods Clinical data of 70 patients with diabetic nephropathy undergoing hemodialysis admitted to Iron Coal General Hospital of Liaoning Health Industry Group from October 2016 to October 2018 were retrospectively analyzed.The patients were divided into the observation group and the control group according to whether Levocarnitine was used before dialysis, with 35 patients in each group.Patients in both groups were treated with high-throughput dialysis.Patients in the control group were not treated with Levocarnitine, and patients in the observation group were given Levocarnitine injection 1.0 g 15 min before each dialysis.The PEW related indexes and bone metabolism indexes before and after treatment were compared between the two groups.Results After treatment, the levels of pre-albumin (PA), albumin (ALB), cholesterol and lean body weight in the observation group were higher than those before treatment, and the levels of C-reactive protein(CRP), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C)in the observation group were lower than those before treatment, and the differences were statistically significant (P＜0.05).There was no statistically significant difference in hemoglobin level in the observation group before and after treatment (P＞0.05).The level of TG in control group after treatment was lower than that before treatment, and the difference was statistically significant (P＜0.05).After treatment, the levels of PA, lean body weight and ALB in the observation group were higher than those in the control group, while the levels of CRP and LDL-C in the observation group were lower than those in the control group, and the differences were statistically significant (P＜0.05).After treatment,there were no significant differences in the levels of hemoglobin, cholesterol, HDL-C and TG between the two groups(P＞0.05).After treatment, the level of parathyroid hormone in the observation group was lower than that in the control group, the level of 25-hydroxyvitamin D3 in the observation group was higher than that in the control group, and the differences were statistically significant (P＜0.05).Conclusion The application of Levocarnitine before hemodialysis in diabetic nephropathy hemodialysis patients can improve PEW and bone metabolism disorders, and is suitable for clinical application.

Key words： Levocarnitine Diabetic nephropathy Dialysis Protein energy expenditure Bone metabolism

引用本文:

吴娱；孙晓梅. 透析前注射左卡尼汀对糖尿病肾病患者蛋白质能量消耗及骨代谢的影响[J]. 中国当代医药, 2021, 28(8): 62-65.
WU Yu；SUN Xiao-mei. Effect of Levocarnitine injection before dialysis on protein energy consumption and bone metabolism in patients with diabetic nephropathy. 中国当代医药, 2021, 28(8): 62-65.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I8/62

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