前列地尔联合左卡尼汀对糖尿病肾病血液透析患者营养指标、肾功能及血清炎症指标的影响
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摘要
目的探讨前列地尔联合左卡尼汀对糖尿病肾病血液透析患者营养指标、肾功能及血清炎症指标等的影响。方法选取2017年5月—2018年4月本院收治的92例糖尿病肾病血液透析患者为研究对象,根据随机数字表法分为观察组(46例)和对照组(46例)。二组患者每周进行2～3次血液透析治疗,对照组在每次透析结束后,给予前列地尔静脉滴注,观察组在对照组基础上另给予左卡尼汀静脉滴注。二组均持续治疗6个月。比较治疗前后肾功能、炎症、营养相关指标变化及WHO生活质量测定量表简表(WHO quality of life-BREF,WHOQOL-BREF)评分变化。结果治疗后,观察组血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)以及尿微球蛋白(β2-microglobulin,β2-MG)水平显著低于对照组(P<0.05);治疗后,观察组血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)和白介素-6(interleukin-6,IL-6)水平显著低于对照组(P<0.05);治疗后,观察组血清血红蛋白(hemoglobin,Hb)、白蛋白(albumin,ALB)、总蛋白(total protein,TP)、转铁蛋白(transferrin,TRF)水平显著高于对照组(P<0.05);治疗后,观察组WHOQOL-BREF量表中生理领域和心理领域评分显著高于对照组(P<0.05)。结论前列地尔联合左卡尼汀可有效改善糖尿病肾病血液透析患者肾功能、微炎症及营养状态,提高患者生活质量。
Objective To investigate the effects of alprostadil combined with L-carnitine on nutritional index, renal function and serum inflammation index in patients with diabetic nephropathy undergoing hemodialysis. Methods From May 2017 to April 2018, ninety-two patients with diabetic nephropathy undergoing hemodialysis who were admitted to People′s Hospital of Deyang City were enrolled in the study and were randomly divided into observation group(46 cases) and control group(46 cases). The patients in two groups were treated with hemodialysis twice or three times a week. The control group was given an intravenous infusion of alprostadil after the end of each dialysis. The observation group was given an intravenous infusion of L-carnitineon the basis of the control group. Both groups continued treatment for 6 months. The changes in renal function, inflammation, nutrition-related indicators and the WHO quality of life-BREF(WHOQOL-BREF) scores were compared before and after treatment. Results After treatment, the levels of blood urea nitrogen(BUN), serum creatinine(Scr) and β2-microglobulin(β2-MG) in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the levels of serum hemoglobin(Hb), albumin(ALB), total protein(TP), transferrin(TRF) in the observation group were significantly higher than those in the control group(P<0.05). After treatment, the scores at each dimension of the WHOQOL-BREF scale in the observation group were significantly higher than those in the control group(P<0.05). Conclusion Alprostadil combined with L-carnitine can effectively improve renal function, micro-inflammation and nutritional status in patients with diabetic nephropathy undergoing hemodialysis, improve the quality of life of patients.
Objective To investigate the effects of alprostadil combined with L-carnitine on nutritional index, renal function and serum inflammation index in patients with diabetic nephropathy undergoing hemodialysis. Methods From May 2017 to April 2018, ninety-two patients with diabetic nephropathy undergoing hemodialysis who were admitted to People′s Hospital of Deyang City were enrolled in the study and were randomly divided into observation group(46 cases) and control group(46 cases). The patients in two groups were treated with hemodialysis twice or three times a week. The control group was given an intravenous infusion of alprostadil after the end of each dialysis. The observation group was given an intravenous infusion of L-carnitineon the basis of the control group. Both groups continued treatment for 6 months. The changes in renal function, inflammation, nutrition-related indicators and the WHO quality of life-BREF(WHOQOL-BREF) scores were compared before and after treatment. Results After treatment, the levels of blood urea nitrogen(BUN), serum creatinine(Scr) and β2-microglobulin(β2-MG) in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the levels of serum hemoglobin(Hb), albumin(ALB), total protein(TP), transferrin(TRF) in the observation group were significantly higher than those in the control group(P<0.05). After treatment, the scores at each dimension of the WHOQOL-BREF scale in the observation group were significantly higher than those in the control group(P<0.05). Conclusion Alprostadil combined with L-carnitine can effectively improve renal function, micro-inflammation and nutritional status in patients with diabetic nephropathy undergoing hemodialysis, improve the quality of life of patients.
引文
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[14] 刘翠萍,王婷婷,高茂龙.左卡尼汀对老年维持性血液透析患者营养状态的影响[J].中国医药,2016,11(8):1188-1192
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[16] 黄朝莉,黄朝莉,谷粒,等.前列地尔联合左卡尼汀对维持性血液透析患者微炎症及营养状态的影响[J].昆明医科大学学报,2017,38(3):87-89
[17] 王晓茹,周秀岚,马惠红.左卡尼汀联合前列地尔治疗糖尿病肾病的临床疗效及其安全性[J].药物评价研究,2017,40(10):1481-1484
[18] 刘翠兰,刘华,程锦绣,等.骨化三醇联合羟苯磺酸钙对糖尿病肾病维持腹膜透析患者微炎症、营养状况和生活质量的影响[J].现代中西医结合杂志,2017,26(11):1179-1181
[19] 钟宇芳,王饶萍,张晓英,等.维持性血液透析患者自我管理水平与生存质量状况及其相关性[J].现代临床护理,2015,14(8):1-4
[2] 宋海燕.肾炎康复片联合前列地尔治疗糖尿病肾病的临床研究[J].中国煤炭工业医学杂志,2015,18(1):52-54
[3] 夏朝霞,路伟,汪代杰,等.左卡尼汀联合前列地尔治疗糖尿病肾病的临床研究[J].中国临床药理学杂志,2016,32(13):1172-1174
[4] 余伍中,高国胜.左卡尼汀对维持性血液透析患者营养指标及炎症状态的影响[J].华西医学,2016,31(1):25-28
[5] 郝元涛,方积乾.世界卫生组织生存质量测定量表中文版介绍及其使用说明[J].中国组织工程研究,2000,4(8):1127-1129
[6] 茶春丽,李靖娟,陈国姝,等.透析患者微炎症状态与血脂代谢及钙磷代谢的相关性[J].昆明医科大学学报,2017,38(1):41-45
[7] 操轩,胡亚琳,陈健.早期糖尿病肾病与胰岛素抵抗及微炎症状态之间关系的研究[J].临床内科杂志,2016,33(1):28-30
[8] 宋洁,李小萍,石理华,等.血液透析与腹膜透析对终末期糖尿病肾病患者微炎症状态的影响[J].河北医药,2012,34(24):3706-3708
[9] 王文素,周建伟,张倩,等.血液灌流对维持性血液透析患者肾性贫血和微炎症状态的影响[J].河北医科大学学报,2016,37(5):585-588
[10] 许琴,赵烨,徐煜,等.血液透析、腹膜透析2种透析方式对慢性肾衰竭尿毒症患者微炎症状态的影响[J].现代中西医结合杂志,2017,26(2):155-156
[11] 李庆,宋学君,李志军.血必净联合前列地尔治疗糖尿病肾病的临床疗效观察[J].中国中西医结合急救杂志,2016,23(3):291-293
[12] 兰海霞,王国团,张卫东.肾康注射液联合前列地尔治疗慢性肾衰竭有效性和安全性的系统评价[J].中国医药,2017,12(8):1208-1212
[13] 贾英民,霍延红,杨永红,等.左卡尼汀治疗终末期肾病维持性血液透析患者心功能不全的临床效果[J].中国医药,2015,10(10):1499-1501
[14] 刘翠萍,王婷婷,高茂龙.左卡尼汀对老年维持性血液透析患者营养状态的影响[J].中国医药,2016,11(8):1188-1192
[15] 苏真,陈建梅.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[J].蚌埠医学院学报,2017,42(10):1349-1352
[16] 黄朝莉,黄朝莉,谷粒,等.前列地尔联合左卡尼汀对维持性血液透析患者微炎症及营养状态的影响[J].昆明医科大学学报,2017,38(3):87-89
[17] 王晓茹,周秀岚,马惠红.左卡尼汀联合前列地尔治疗糖尿病肾病的临床疗效及其安全性[J].药物评价研究,2017,40(10):1481-1484
[18] 刘翠兰,刘华,程锦绣,等.骨化三醇联合羟苯磺酸钙对糖尿病肾病维持腹膜透析患者微炎症、营养状况和生活质量的影响[J].现代中西医结合杂志,2017,26(11):1179-1181
[19] 钟宇芳,王饶萍,张晓英,等.维持性血液透析患者自我管理水平与生存质量状况及其相关性[J].现代临床护理,2015,14(8):1-4