目的 观察左旋肉碱对维持性血液透析患者胰岛素抵抗（IR）的影响。方法 选择尿毒症维持 血液透析患者40例，随机分成2组，治疗组20例、对照组20例，治疗组于每次透析后静脉注射左旋肉碱1.0g，对照组静脉注射5ml生理盐水 ，疗程共12周。另设正常对照组10例。用空腹血糖与空腹胰岛素浓度乘积的倒数即胰岛素敏感指数(ISI)作为胰岛素敏感指标。采用放免法测定胰岛素水平。常规方法检测总胆固醇、甘油三脂等指标。结果 治疗组肉碱治疗12周后患者ISI较治疗前显著提高（ P<0.05）。对照组 ISI无显著性变化。结论 维持性血液透析患者存在IR现象，左旋肉碱能改善维持性血液透析患者IR。

Objective To investigate the effect of L-carnitine on insulin resistance in patients undergoing hemodialysis.Methods Forty patients undergoing hemodialysis were randomly divided into 2 groups. The therapy group were intravenously infused 1.0g of L-carnitine after every dialysis session; Control group were intravenously given 5ml saline. The reverse of fasting plasma glucose and insulin concentration product were used as index of insulin resistance. We observed for 12 weeks. Results In therapy group,the index of insulin resistance was significantly increased (P < 0.05) while No significant change was found in control group. Conclusion There is the presence of IR in patients undergoing hemodialysis; L-carnitine may improve the insulin resistance of hemodialysis patients.