海南医科大学学报

目的:探讨替米沙坦联合左卡尼汀对腹膜透析(PD)患者营养状态的影响。方法:选择我科2011年11月~2014年1月随访的80例慢性肾功能衰竭(CRF)接受PD患者为研究对象,随机分为治疗组与对照组;两组均进行PD,治疗组给予左卡尼汀口服液10mL/次、3次/d,替米沙坦80mg/次、1次/d,对照组给予左卡尼汀口服液10mL/次、3次/d,两组均连续服用24周;于治疗前后抽取清晨空腹肘静脉血5mL,采用自动生化分析仪检测血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PA)、甘油三酯(TG)、胆固醇(TC);体表测量肱三头肌处皮褶厚度(TSF)、上臂围(MAC),计算上臂肌围(MAMC);使用改良主观全面营养评价法(SGA)对患者进行营养评估。结果:治疗后,治疗组Hb、Alb、PA升高,TG下降,与治疗前比较有统计意义(P<0.05),TC无显著改变(P<0.05),对照组与治疗前无统计意义(P<0.05),治疗组优于对照组(P<0.05);治疗后治疗组体重指数(BMI)、MAMC、TSF升高,SGA降低,与治疗前比较有统计学意义(P<0.05),对照组与治疗前比较无统计学意义(P<0.05),治疗组优于对照组(P<0.05)。结论:替米沙坦联合左卡尼汀用于PD患者,能够有效改善营养不良状态,纠正脂质代谢紊乱,从而延缓残余肾功能(RRF)的丧失。

Objective:To explore the effect of telmisartan in combined with levocarnitine on the nutritional status in patients for peritoneal dialysis(PD).Methods:A total of 80 patients with chronic renal failure(CRF)who were admitted in our hospital from November,2011 to January,2014 were included in the study and randomized into the treatment group and the control group.The patients in the two groups were performed with PD.The patients in the treatment group were given levocarnitine oral solution,10mL/time,3times/d,and telmisartan,80mg/time,1time/d.The patients in the control group were only given levocarnitine oral solution,10mL/time,3times/d.The patients in the two groups were continuously administrated for 24 weeks.A volume of 5mL morning fasting elbow venous blood was extracted before and after treatment.The automatic biochemical analyzer was used to detect Hb,Alb,PA,TG,and TC.TSF and MAC were measured.MAMA was calculated.SGA was used to evaluate the nutrition.Results:After treatment,Hb,Alb,and PA in the treatment group were significantly elevated,while TG was significantly reduced when compared with before treatment(P <0.05),TC was not significantly changed(P>0.05),those after treatment in the control group were not significantly different from those before treatment(P>0.05),and those in the treatment group were significantly superior to those in the control group(P<0.05).After treatment,BMI,MAMC,and TSF in the treatment group were significantly elevated,while SGA was significantly reduced when compared with before treatment(P<0.05),those after treatment in the control group were not significantly different from those before treatment(P>0.05),and those in the treatment group were significantly superior to those in the control group(P<0.05).Conclusions:Telmisartan in combined with levocarnitine in application of PD patients can effectively improve the malnutrition,and correct the lipid metabolism disorder to delay the loss of residual renal function(RRF).