左卡尼汀对糖尿病肾病透析病人炎性因子与红细胞免疫的影响
Effect of L-carnitine on inflammatory factors and RBC immunity in diabetic nephropathy patients treated with dialysis
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摘要: 目的：观察静脉推注左卡尼汀对糖尿病肾病（DN）维持性血液透析（MHD）病人炎性因子与红细胞免疫功能的影响。方法：将89例MHD病人随机分为观察组（47例）和对照组（42例），2组均给予血液透析治疗，每周2~3次，每次4 h，观察组在每次透析结束前5 min静脉推注左卡尼丁注射液，每次1 g，治疗1个月、3个月后，2组采外周血检测炎性因子与红细胞免疫指标。结果：伴随治疗时间延长，观察组白细胞介素-6、肿瘤坏死因子-α、高敏-C反应蛋白逐步下降，对照组下降不明显；观察组治疗1个月、3个月后上述炎性因子水平显著低于对照组（P<0.01）。2组病人治疗后红细胞C3b受体花环百分比、CD35阳性RBC百分比、超氧化物歧化物水平逐步上升，红细胞免疫复合物花环百分比逐步下降；观察组治疗1个月、3个月后红细胞C3b受体花环百分比、CD35阳性RBC高于对照组（P<0.05~P<0.01），而治疗1个月、3个月后红细胞免疫复合物花环百分比则显著低于对照组（P<0.01）。结论：对MHD治疗的DN病人补充外源性左卡尼汀可明显改善病人微炎性反应状态，同时能提高红细胞免疫功能。Abstract: Objective:To observe the effects of L-carnitine injection on inflammation and red blood cell(RBC) immune function in diabetic nephropathy(DN) patients treated with maintenance hemodialysis(MHD).Methods:Eighty-nine MHD patients were randomly into the observation group(47 cases) and control group(42 cases).Two groups were treated with peritoneal dialysis,2 to 3 times a week,4 h each time.The observation group was intravenously injected with L-carnitine for 5 min before the end of the dialysis,1 g each time.The inflammatory factors and RBC immune indexes in two groups were detected after 1 and 3 months of treatment.Results:With the prolonging of treatment,the levels of IL-6,TNF-α,and hs-CRP in observation group declined gradually,and the decreasing degree of those in control group was not obvious.The levels of inflammatory factors in observation group after 1 month and 3 months of treatment were significantly lower than those in control group(P< 0.01).After treatment,the percentages of RBC-C3bRR wreath and CD35 positive RBC,and level of SOD gradually increased,and the percentage of RBC-ICR wreath declined gradually in two groups.After 1 month and 3 months of treatment,the percentages of RBC-C3bRR wreath and CD35 positive RBC in observation group were significantly higher than those in control group(P<0.05 to P<0.01),but the percentage of RBC-ICR wreath in observation group after 1 month and 3 months of treatment was significantly lower than that in control group(P<0.01).Conclusions:The exogenous L-carnitine in DN patients treated with MHD can obviously improve micro-inflammation status,and erythrocyte immune function.
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Key words:
- diabetic nephropathy /
- hemodialysis /
- L-carnitine /
- inflammatory factor /
- red blood cell immunity
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