Clinical efficacy of levocarnitine combined with Jinshuibao in the treatment of patients with chronic renal failure undergoing maintenance hemodialysis#br#
HE Xue1, YIN Fang2
(1. Department of Nephrology and Rheumatology, 2. Department of Infection, Yongchuan Hospital Affiliated to Chongqing Medical University, Chongqing 402160, China)
Abstract：Objective: To evaluate the clinical effect of levocarnitine combined with Jinshuibao on patients with chronic renal failure patients undergoing maintenance hemodialysis. Methods: Ninetytwo patients with chronic renal failure who underwent maintenance hemodialysis in Yongchuan Hospital Affiliated to Chongqing Medical University from June 2018 to February 2021 were selected in the study, and were randomly divided into the treatment group (n=46) and the control group (n=46). The control group was treated with levocarnitine, and the treatment group was treated with Jinshuibao on the basis of the control group. Clinical efficacy and level of inflammatory factors, matrix metalloproteinases, nutritional indicators, stromal cell-derived factor-1 (SDF-1), vitamin D and vitamin B12 in serum were compared between the two groups. Results:After treatment, the total clinical effective rate of treatment group (89.13%) was significantly higher than that of control group (69.57%, P<0.05). After treatment, the levels of tumor necrosis factor-α(TNF-α), IL-6, C-reactive protein (CRP), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and SDF-1 in 2 groups were significantly decreased compared with before treatment(all P<0.05). The levels of total protein, albumin, hemoglobin, vitamin D and vitamin B12 were higher than those before treatment(all P<0.05); and the contents of TNF-α, IL-6, CRP, MMP-2, MMP-9 and SDF-1 in treatment group were lower than those in control group (P<0.05), and the levels of total protein, albumin, hemoglobin, vitamin D and vitamin B12 in treatment group were higher than those in control group(P<0.05). There was no significant difference in the incidence of adverse reactions and complication between the two groups(both P＞0.05). Conclusion: Levocarnitine combined with Jinshuibao could improve the clinical efficacy, reduce microinflammatory reaction, improve nutritional status in patients with chronic renal failure undergoing maintenance hemodialysis.
Key words：
收稿日期: 2021-08-05
基金资助:重庆市教育委员会项目(KJQN201900420)
通讯作者:
殷芳(通讯作者)，E-mail: Ahappy2021@126.com
作者简介: 何雪(1990—)，女，硕士研究生，住院医师；
引用本文:
何雪，殷芳. 左卡尼汀联合金水宝治疗维持性血液透析慢性肾功能衰竭患者的临床效果观察[J]. 江苏大学学报:医学版, 2022, 32(02): 156-160,166.
HE Xue, YIN Fang. Clinical efficacy of levocarnitine combined with Jinshuibao in the treatment of patients with chronic renal failure undergoing maintenance hemodialysis#br#. Journal of Jiangsu University(Medicine Edition), 2022, 32(02): 156-160,166.
［1］张燕. 格林模式生活方式干预在维持性血液透析患者心血管并发症中的应用研究［J］. 护士进修杂志, 2019, 34(3): 272-274.
［2］孔曼丽, 李若和, 吴倩. 综合护理干预对行维持性血液透析患者并发症发生率及满意度的影响［J］. 中国农村卫生事业管理, 2018, 38(5): 667-669.
［3］Spatola L, Finazzi S, Calvetta A, et al. Subjective lobal AssessmentDialysis Malnutrition Score and cardiovascular risk in hemodialysis patients: an observational cohort study［J］. J Nephrol, 2018, 31(5): 757-765.
［4］高祖玲,杨海俊,熊维建.维持性血液透析患者微炎症状态的研究进展［J］.重庆医学, 2018, 47(22): 2963-2965, 2968.
［5］张俊,刘永光.基质细胞衍生因子1与血液透析患者炎症及营养标志物的相关性研究［J］.中国医学工程, 2020, 28(7): 9-13.
［6］熊芮,樊丹丹,薛贵方.血液透析滤过联合左卡尼汀对老年肾病血液透析患者肝肾功能指标及贫血的影响［J］.中南医学科学杂志, 2019, 47(6): 610-612，616.
［7］禚丽琴,姚丹丹,仇方忻. 金水宝片对维持性血液透析患者微炎症状态及营养状况的影响［J］. 中国医药导刊, 2019, 21(11): 679-682.
［8］中华中医药学会. 慢性肾衰竭诊疗指南［J］. 中国中医药现代远程教育, 2011, 9(9): 132-133.
［9］中国医师协会肾脏病医师分会血液透析充分性协作组. 中国血液透析充分性临床实践指南［J］.中华医学杂志, 2015, 95(34): 2748-2753.
［10］汪朝阳,王敏,景玲.金水宝片联合依诺肝素对维持性血液透析患者血脂代谢的影响［J］.世界中医药, 2020, 15(12): 1771-1773, 1777.
［11］胡美玲, 蒙如庆. 维持性血液透析患者微炎症状态的治疗进展［J］. 医学综述, 2019, 25(1): 87-92.
［12］Zhang X, Li J, Yang B, et al. Alleviation of liver dysfunction, oxidative stress, and inflammation underlines the protective effects of polysaccharides from Cordyceps cicadae on high sugar/high fat dietinduced metabolic syndrome in rats［J］. Chem Biodivers, 2021, 18(5): e2100065.
［13］Chen Y, Wang T, Zhang X, et al. Structural and immunological studies on the polysaccharide from spores of a medicinal entomogenous fungus Paecilomyces cicadae［J］.Carbohydr Polym, 2021, 254(1): 117462.
［14］de Almeida HRM, Santos EMC, Dourado K, et al. Malnutrition associated with inflammation in the chronic renal patient on hemodialysis［J］. Rev Assoc Med Bras (1992), 2018, 64(9): 837-844.
［15］Allawi AAD. Malnutrition, inflamation and atherosclerosis (MIA syndrome) in patients with end stage renal disease on maintenance hemodialysis (a single centre experience)［J］. Diabetes Metab Syndr, 2018, 12(2): 91-97.
［16］胡永玮,宋素珍,闵群燕,等.不同血液透析方式对患者营养及微炎症状态的影响［J］.江苏大学报(医学版), 2014, 24(2): 134-138.
［17］仲海峰,黄新忠,周永华,等.不同透析方式对老年终末期肾病患者动态动脉硬化指数(AASI)的影响分析［J］.中南医学科学杂志, 2019, 47(2): 184-187.
［18］Finkelstein JL, Herman HS, Plenty A, et al. Anemia and micronutrient status during pregnancy, and their associations with obstetric and infant outcomes among HIVinfected Ugandan women receiving antiretroviral therapy［J］. Curr Dev Nutr, 2020, 4(5): nzaa075.
［19］Houghton LA, TrilokKumar G, McIntosh D, et al. Multiple micronutrient status and predictors of anemia in young children aged 12-23 months living in New Delhi, India［J］. PLoS One, 2019, 14(2): e0209564.
［20］Pawlak K, Pawlak D, Myliwiec M. Urokinasetype plasminogen activator and metalloproteinase2 are independently related to the carotid atherosclerosis in haemodialysis patients［J］. Thromb Res, 2008, 121(4): 543-548.
