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目的 :探讨尿毒症血液透析患者的卡尼汀 (肉碱 )代谢并观察补充左卡尼汀的作用。方法 :取透析前后血测血浆游离卡尼汀 ( FC)浓度 ,研究卡尼汀与血液透析时间、肌酐清除率 ( Ccr)、食欲及透析中低血压、肌痉挛和透析后虚弱无力的关系 ;左卡尼汀补充 3个月 ,观察血浆 FC浓度变化和临床症状的改善。结果 :尿毒症血液透析患者血浆FC浓度明显低于正常人 ( P<0 .0 1) ,且与血液透析时间直接相关 ,一次血液透析血浆 FC浓度下降 70 % ;血浆浓度与透析中低血压、肌痉挛及透析后虚弱无力相关 ;左卡尼汀补充后 ,血浆浓度可升高 4倍 ,临床症状明显改善。结论 :尿毒症血液透析患者存在明显的卡尼汀缺乏 ,补充左卡尼汀可提高血浆浓度 ,可减少与卡尼汀缺乏有关的血液透析并发症
Objective: To investigate the carnitine (carnitine) metabolism in hemodialysis patients with uremia and to observe the effect of levocarnitine supplementation. Methods: Before and after dialysis, plasma concentration of free carnitine (FC) was measured to study the relationship between carnitine and hemodialysis time, creatinine clearance rate (Ccr), appetite and dialysis middling hypotension, muscle spasms and post-dialysis weakness. L-carnitine was added for 3 months to observe the change of plasma FC concentration and the improvement of clinical symptoms. Results: The concentration of plasma FC in hemodialysis patients with uremia was significantly lower than that in normal people (P <0.01), and was directly related to hemodialysis time. The concentration of FC in serum of a hemodialysis patients decreased by 70% Muscle spasms and weakness after dialysis related; L-carnitine supplementation, the plasma concentration can be increased 4 times, significantly improved clinical symptoms. Conclusions: There is a significant carnitine deficiency in uremic hemodialysis patients. L-carnitine supplementation can increase plasma concentration and reduce the complications of hemodialysis associated with a lack of carnitine