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左卡尼汀对维持性血液透析患者T淋巴细胞亚群及其营养状态的影响
Effects of levocarnitine on T-lymphocyte subsets and nutritional status of maintenance hemodialysis patients
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DOI:
作者:
郭洁,袁利,陈永华,谢平,徐贵华
Guo Jie,Yuan Li,Chen Yonghua,Xie Ping,Xu Guihua
作者单位:
上海市第八人民医院肾内科
Department of nephrology, Shanghai Eighth People's Hospital
关键词:
左卡尼汀;T淋巴细胞亚群;维持性血液透析
levocarnitine; T-lymphocyte subsets; maintenance hemodialysis
摘要:
目的 探讨左卡尼汀对维持性血液透析(MHD)患者T淋巴细胞亚群及其营养状态的影响。 方法 选择40例在我院血液透析中心治疗的MHD患者,随机分为观察组和对照组,每组均为20例。两组均采用维持性血液透析等常规治疗,观察组加用左卡尼汀治疗3个月。分别在治疗前和治疗后检测血常规、营养状态等指标,同时采用细胞免疫芯片法检测患者T淋巴细胞亚群。 结果 两组患者治疗前血红蛋白(Hb)、红细胞压积(Hct)、白蛋白(Alb)、前白蛋白(PA)、胆固醇(TC)、甘油三酯(TG)、脂蛋白[LP(a)]、蛋白分解代谢率(PCR)、超敏CRP(hsCRP)无统计学差异。治疗3个月后,观察组Hb、Hct、Alb、PA、PCR明显升高(P<0.05), LP(a)、hsCRP明显降低(P<0.05);对照组无明显变化。两组患者治疗前T淋巴细胞亚群CD3+ 、CD4+ 、CD8+、 CD4+/CD8+比值无统计学差异。治疗3个月后,观察组CD3+ 、CD4+及CD4+/CD8+比值明显增加(P<0.05),CD8+变化无统计学意义;对照组无明显变化。 结论 左卡尼汀可部分调节MHD患者T淋巴细胞亚群,并改善其营养状态。
Objective To investigate the effects of levocarnitine on T-lymphocyte subsets and nutritional status of maintenance hemodialysis (MHD) patients. Methods 40 cases of MHD patients treated in our hemodialysis center were randomly divided into observation group(n=20) and control group(n=20). The control group was treated with conventional therapy ,including maintenance hemodialysis, blood pressure control and correction of anemia ,etc ;and the observation group based on the conventional therapy was additionally treated with L-carnitine for 3 months. The indicators of anemia and nutritional status were detected before and after treatment, while T lymphocyte subsets were detected by the method of cellular immune chip . Results In two groups, before treatment there was no significant difference in the level of hemoglobin(Hb), hematocrit(Hct),albumin(Alb), prealbumin(PA), Cholesterol(TC),triglyceride(TG),lipoprotein[Lp(a)], protein catabolic rate(PCR), urea clearance(Kt/V) and hypersensitive CRP(hsCRP). After treatment of 3 months, in observation group ,the level of Hb, Hct, Alb, PA and PCR was significantly increased (P<0.05);while the level of LP(a), hsCRP decreased significantly (P <0.05); there was no significant difference of the above indicators in the control group. In two groups, before treatment there was no significant difference in T-lymphocyte subsets(CD3+,CD4+,CD8+ and ratio of CD4+/CD8+. After the treatment of 3 months, in observation group, the level of CD3+,CD4+ and ratio of CD4+/CD8+ significantly increased (P<0.05) ;the level of CD8+ has no significant change. There was no significant difference of the above indicators in the control group. Conclusion L-carnitine may not only improve the nutritional status of maintenance hemodialysis patients, but also regulate T-lymphocyte subsets and enhance cellular immune functional of the patients.
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