| 摘要: |
| 目的：观察慢性肾衰患者的肉碱代谢以指导临床治疗。方法：选择慢性肾衰保守治疗患者以及尿毒症血透患者为实验对象,并以正常人作对照，检测血浆游离肉碱(FC)浓度。结果：(1)慢性肾衰保守治疗患者血浆FC浓度明显高于正常人(P<0.05),并与血清尿素氮、尿酸显著相关(r=0.666 0,r=0.642 1,P<0.05),与血清肌酸酐无关。(2)尿毒症血透患者透前血浆FC浓度明显低于正常人和保守治疗患者(P<0.01)，透后浓度显著低于透前(P<0.001)；一次血透后浓度下降70％。另外,血透患者血浆FC浓度与血透时间呈非常显著相关(r=-0.879 3,P<0.001),与肌酸酐清除率无关。结论：慢性肾衰患者存在明显的肉碱代谢异常,特别是血透患者FC缺乏，血透后及时给予补充肉碱是必要的。 |
| 关键词: 肾功能衰竭，慢性 血液透析 肉碱代谢 |
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| Carnitine metabolism in patients with chronic renal failure |
| 陈蕾,梅长林,王勇平,徐洪实 |
| () |
| Abstract: |
| Objective: To observe the metabolism of carnitine in patients with chronic renal failure(CRF).Methods:The plasma free carnitine(FC) concentrations were monitored in the undialyzed and dialyzed patients with CRF and normal subjects.Results: (1)Plasma FC concentration in undialyzed patients with CRF was significantly higher than that in normal subjects(P<0.05),and it was closely correlated with blood urea nitrogen(r=0.666 0) and uric acid(r=0.642 0,P<0.05),not correlated with serum creatinine.(2)Predialysis plasma FC concentration in dialyzed patients was much lower than that in normal subjects and undialyzed patients(P<0.01),postdialysis plasma FC concentration was significantly lower than predialysis concentration(P<0.001). There was a 70%decline in plasma FC concentration during one hemodialysis session.Furthermore,plasma FC concentration was very significantly correlated with dialysis time(r=-0.879 3,P<0.001),not correlated with creatinine clearance rate. Conclusion: There is obvious carnitine metabolism disturbance in patients with CRF,especially in hemodialyzed patients whose plasma FC was deficient.So,it is essential for hemodialyzed patients to be timely supplemented with carnitine after hemodialysis. |
| Key words: kidney failure, chronic hemodialysis carnitine metabolism |
