左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究

沈燕; 卢宗亮; 袁静; 何珊; 孙海岚; 郭静; 查艳; 许红霞

您当前的位置：

首页 >

文章列表页 >

左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究

临床医学 | 更新时间：2026-01-09

- 左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究
- A retrospective study of L-carnitine treatment in maintenance hemodialysis patients with protein-energy wasting
- 陆军军医大学学报 2016年38卷第18期页码：2071-2076
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R459.5;R692.506;R977.4
- 纸质出版：2016
- 稿件说明：
移动端阅览
沈燕,卢宗亮,袁静,何珊,孙海岚,郭静,查艳,许红霞.左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(18):2071-2076.

　Shen Yan,Lu Zongliang,Yuan Jing,He Shan,Sun Hailan,Guo Jing,Zha Yan,Xu Hongxia.A retrospective study of L-carnitine treatment in maintenance hemodialysis patients with protein-energy wasting[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(18):2071-2076.
沈燕,卢宗亮,袁静,何珊,孙海岚,郭静,查艳,许红霞.左卡尼汀治疗维持性血液透析患者蛋白质能量消耗疗效的回顾性研究[J].陆军军医大学学报(原第三军医大学学报),2016,38(18):2071-2076. DOI：

　Shen Yan,Lu Zongliang,Yuan Jing,He Shan,Sun Hailan,Guo Jing,Zha Yan,Xu Hongxia.A retrospective study of L-carnitine treatment in maintenance hemodialysis patients with protein-energy wasting[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(18):2071-2076. DOI：

摘要

目的研究左卡尼汀治疗维持性血液透析(maintenance hemodialysis，MHD)患者蛋白质能量消耗（protein energy wasting

PEW）的效果。方法回顾性选取2003年1月至2015年6月在贵州省人民医院进行维持性血液透析并诊断为PEW患者99例。按患者是否使用左卡尼汀分为治疗组和对照组，其中治疗组75例，对照组24例。采用独立样本t检验和χ

检验比较两组患者生化指标（包括白蛋白、前白蛋白、血红蛋白、淋巴细胞总数等）、主观全面营养评估(subjective global assessment，SGA)评分、体格测量（包括体质量、体质量指数、上臂肌围、肱三头肌皮褶厚度、小腿围）和人体成分测量（瘦体质量、脂肪质量和相位角）结果。结果左卡尼汀治疗组治疗后血红蛋白、前白蛋白、白蛋白较治疗前升高，差异有统计学意义（P0.05），也高于对照组（P0.05）。用SGA评分判断，治疗组营养良好患者比例高于对照组（22.7% vs 4.2%），而轻中度营养不良和重度营养不良患者比例均显著低于对照组（76.0% vs 83.3%，1.3% vs 12.5%），差异有统计学意义（P0.05）。体格测量显示，治疗组男性和女性的体质量指数、肱三头肌皮褶厚度、小腿围均分别高于对照组，差异有统计学意义（P0.05）。生物电阻抗法检测体质成分结果显示，治疗组瘦体质量明显高于对照组（P0.05），但脂肪质量和相位角较对照组差异无统计学意义（P0.05）。结论 MHD患者经左卡尼汀治疗可有效改善营养状况，预防患者体质量丢失，尤其是瘦体质量的丢失，从而改善患者的PEW，有望将来用于预防MHD患者的肌肉减少症，提高生活质量。

Abstract

Objective To study the therapeutic effects of L-carnitine in maintenance hemodialysis (MHD) patients with protein-energy wasting (PEW). Methods A total of 99 MHD patients with PEW recruited between Jan 2003 and June 2015 in the Department of Nephrology at People’s Hospital of Guizhou Province was retrospectively studied. The patients were divided into 2 groups: 75 patients were treated with 1 g/d L-carnitine (i.v. injected

3 d per week) over 6 months (LC group)

and 24 patients admitted to the same treatment except L-Carnitine (control group). Biochemical test including hemoglobin (HB)

pre-albumin (PA)

albumin (ALB) and total lymphocyte count

subjective global assessment (SGA)

anthropometric measurement including body weight

body mass index (BMI)

triceps skin fold thickness (TSF) and calf circumference (CC)

and body composition measurement including lean body mass (LBM)

fat mass and bioimpedance phase angle (PA) were studied for all the patients. Bioelectrical impedance analysis (BIA) was used for measurement of LBM

fat mass and PA. The difference of these indexes between the 2 groups was statistically assessed by independent sample t-test and chi-square analysis. Results The increase of HB

PA and ALB between pre-and post-treatment were statistically significant in LC group (P0.05). Also

the increase after L-carnitine treatment was significant compared to the control group (P0.05). The SGA examination showed that in control group

12.5% (3/24) of patients were severe malnourished

83.3% (20/24) of patients were mild-to-moderate malnourished

and only 4.2% of (1/24) patients were non-malnourished. By contrast

in LC group the percentages of patients in severe

mild-to-moderate

and non-malnutritions were 1.3% (1/75)

76.0% (57/75) and 22.7% (17/75)

respectively. The malnutrition difference between the 2 groups suggested the therapeutic benefit of L-Carnitine in MHD patients with PEW. In addition

BMI

TSF and CC in male and female patients were significantly better than those in control group separately (P0.05). Compared to the control group

LBM was significantly higher in LC group

but no significant difference in fat mass and PA was found between the 2 groups(P0.05). Conclusion Our findings suggest that routine L-carnitine treatment could effectively improve the nutritional status and prevent body weight loss

especially LBS

in MHD patients with PEW. Thus

L-carnitine treatment may be used as a potential therapy in the prevention of sarcopenia

and consequently improving patients’ quality of life in the future.

关键词

Keywords

references

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据