中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
16期
1-4
,共4页
血液透析滤过%凋亡诱导因子%生长调节素类%左卡尼汀
血液透析濾過%凋亡誘導因子%生長調節素類%左卡尼汀
혈액투석려과%조망유도인자%생장조절소류%좌잡니정
Hemodiafiltration%Apoptosis inducing factor%Somatomedins%L-carnitine
目的 观察左卡尼汀对维持性血液透析(MHD)患者血浆可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)蛋白的影响.方法 选择46例MHD患者作为MHD组,另选择同期健康体检者40例作为对照组.采用酶联免疫吸附法(ELISA)检测血浆sTWEAK、高敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6及血浆胰岛素样生长因子(IGF)-1水平.26例血浆sTWEAK蛋白水平高于对照组平均值的MHD患者作为治疗组,20例低于或等于对照组平均值的MHD患者作为未治疗组.治疗组给予左卡尼汀1.0 g加入0.9％氯化钠溶液20 ml每周1次血液透析后静脉推注,治疗3个月后观察sTWEAK、IGF-1、握力及蛋白能量消耗(PEW)等变化.结果 MHD组血浆sTWEAK蛋白、IL-6、hs-CRP均高于对照组[(464±102) ng/L比(346±159) ng/L、(986.54±123.12) ng/L比(407.12±180.25) ng/L、(18.8±2.9) mg/L比(1.0±1.2) mg/L],差异有统计学意义(P＜0.01).与未治疗组比较,治疗组治疗3个月后血浆sTWEAK蛋白、IL-6、hs-CRP明显下降[(126±92) ng/L比(243±103) ng/L、(799.45±105.34) ng/L比(966.04±113.11)ng/L、(13.7±1.9) mg/L比(26.8±2.8)mg/L],IGF-1明显升高,握力增加,PEW改善,差异均有统计学意义(P＜0.01或＜0.05).治疗组体质量指数虽较未治疗组增加,但比较差异无统计学意义(P＞0.05).结论 左卡尼汀可降低MHD患者血浆sTWEAK蛋白水平,减轻炎性反应状态,提高IGF-1水平,增加握力,改善PEW.
目的 觀察左卡尼汀對維持性血液透析(MHD)患者血漿可溶性腫瘤壞死因子樣凋亡弱誘導因子(sTWEAK)蛋白的影響.方法 選擇46例MHD患者作為MHD組,另選擇同期健康體檢者40例作為對照組.採用酶聯免疫吸附法(ELISA)檢測血漿sTWEAK、高敏C反應蛋白(hs-CRP)、白細胞介素(IL)-6及血漿胰島素樣生長因子(IGF)-1水平.26例血漿sTWEAK蛋白水平高于對照組平均值的MHD患者作為治療組,20例低于或等于對照組平均值的MHD患者作為未治療組.治療組給予左卡尼汀1.0 g加入0.9％氯化鈉溶液20 ml每週1次血液透析後靜脈推註,治療3箇月後觀察sTWEAK、IGF-1、握力及蛋白能量消耗(PEW)等變化.結果 MHD組血漿sTWEAK蛋白、IL-6、hs-CRP均高于對照組[(464±102) ng/L比(346±159) ng/L、(986.54±123.12) ng/L比(407.12±180.25) ng/L、(18.8±2.9) mg/L比(1.0±1.2) mg/L],差異有統計學意義(P＜0.01).與未治療組比較,治療組治療3箇月後血漿sTWEAK蛋白、IL-6、hs-CRP明顯下降[(126±92) ng/L比(243±103) ng/L、(799.45±105.34) ng/L比(966.04±113.11)ng/L、(13.7±1.9) mg/L比(26.8±2.8)mg/L],IGF-1明顯升高,握力增加,PEW改善,差異均有統計學意義(P＜0.01或＜0.05).治療組體質量指數雖較未治療組增加,但比較差異無統計學意義(P＞0.05).結論 左卡尼汀可降低MHD患者血漿sTWEAK蛋白水平,減輕炎性反應狀態,提高IGF-1水平,增加握力,改善PEW.
목적 관찰좌잡니정대유지성혈액투석(MHD)환자혈장가용성종류배사인자양조망약유도인자(sTWEAK)단백적영향.방법 선택46례MHD환자작위MHD조,령선택동기건강체검자40례작위대조조.채용매련면역흡부법(ELISA)검측혈장sTWEAK、고민C반응단백(hs-CRP)、백세포개소(IL)-6급혈장이도소양생장인자(IGF)-1수평.26례혈장sTWEAK단백수평고우대조조평균치적MHD환자작위치료조,20례저우혹등우대조조평균치적MHD환자작위미치료조.치료조급여좌잡니정1.0 g가입0.9％록화납용액20 ml매주1차혈액투석후정맥추주,치료3개월후관찰sTWEAK、IGF-1、악력급단백능량소모(PEW)등변화.결과 MHD조혈장sTWEAK단백、IL-6、hs-CRP균고우대조조[(464±102) ng/L비(346±159) ng/L、(986.54±123.12) ng/L비(407.12±180.25) ng/L、(18.8±2.9) mg/L비(1.0±1.2) mg/L],차이유통계학의의(P＜0.01).여미치료조비교,치료조치료3개월후혈장sTWEAK단백、IL-6、hs-CRP명현하강[(126±92) ng/L비(243±103) ng/L、(799.45±105.34) ng/L비(966.04±113.11)ng/L、(13.7±1.9) mg/L비(26.8±2.8)mg/L],IGF-1명현승고,악력증가,PEW개선,차이균유통계학의의(P＜0.01혹＜0.05).치료조체질량지수수교미치료조증가,단비교차이무통계학의의(P＞0.05).결론 좌잡니정가강저MHD환자혈장sTWEAK단백수평,감경염성반응상태,제고IGF-1수평,증가악력,개선PEW.
Objective To observe the effect of L-carnitine on plasma soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) protein in maintenance hemodialysis (MHD) patients.Methods Forty-six cases of MHD patients were enrolled as MHD group,and 40 cases of the same period healthy subjects were enrolled as control group.The levels of plasma sTWEAK protein,high-sensitivity C-reactive protein (hs-CRP),interleukin (IL)-6 and insulin-like growth factor (IGF)-1 were measured by enzyme-linked immunosorbent assay (ELISA).Twenty-six MHD patients with the levels of sTWEAK protein higher than control group mean value as treatment group,were treated for L-carnitine 1.0 g in 0.9％ sodium chloride solution 20 ml after hemodialysis by intravenous injection one time per week.Twenty MHD patients with the levels of sTWEAK protein lower than or equal to control group mean value as non-treatment group.The changes of sTWEAK protein,IGF-1,grip strength and protein energy waisting (PEW) were observed after 3 months treatment.Results The levels of plasma sTWEAK protein,IL-6 and hs-CRP in MHD group were higher than those in control group [(464 ± 102) ng/L vs.(346 ± 159) ng/L,(986.54 ± 123.12) ng/L vs.(407.12 ± 180.25) ng/L,(18.8 ± 2.9) mg/L vs.(1.0 ± 1.2) mg/L],there were significant differences (P＜ 0.05).Compared with non-treatment group,the levels of plasma sTWEAK protein,IL-6 and hs-CRP in treatment group after treatment of 3 months were decreased [(126 ± 92) ng/L vs.(243 ± 103) ng/L,(799.45 ± 105.34) ng/L vs.(966.04 ± 113.11) ng/L,(13.7 ± 1.9) mg/L vs.(26.8 ± 2.8) mg/L],IGF-1 was increased,grip strength was increased,PEW was improved,there were significant differences (P ＜ 0.01 or ＜ 0.05).The body mass index in treatment group was more than that in non-treatment group,but there was no significant difference (P ＞ 0.05).Conclusions L-carnitine can reduce the levels of plasma sTWEAK protein in MHD patients,reduce inflammatory reaction,improve the levels of IGF-1,increase strength,improve the PEW.
