中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (03): 117-120.

• 临床研究 • 上一篇    下一篇

左卡尼汀对维持性血液透析患者血脂代谢影响的Meta分析

胡小红,陶煜,钱一欣,等   

  1. 第二军医大学附属长征医院肾内科,解放军肾脏病研究所
  • 收稿日期:2012-08-10 修回日期:2012-09-17 出版日期:2013-03-12 发布日期:2015-10-08
  • 通讯作者: 郁胜强 E-mail:huxiaohong8305@163.com

  • Received:2012-08-10 Revised:2012-09-17 Online:2013-03-12 Published:2015-10-08

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摘要： [目的] 应用Meta分析方法评价维持性血液患者应用左卡尼汀后血脂代谢的变化。 [方法] 检索PubMed、EMBASE、Cochrane library等数据库，全面收集相关文献。制定文献纳入标准，符合纳入标准的文献按Jadad评分进行文献质量评估。应用Review Manager5.0软件进行Meta分析，计算血透患者应用左卡尼汀组和对照组的总胆固醇、甘油三酯、低密度脂蛋白以及高密度脂蛋白的加权均数差值（WMD）及其95%CI。 [结果]（1）共检索到符合纳入标准的相关文献9篇，均为英文文献，研究内容为维持性血液透析患者应用左卡尼汀治疗或安慰剂对照，纳入分析的患者共259例，其中左卡尼汀治疗组134例, 对照组125例，随访时间12周至6个月。（2）Meta分析结果提示：①维持性血液透析患者左卡尼汀组总胆固醇水平较对照组有降低倾向，但无统计学差异。②两组间甘油三酯水平、高密度脂蛋白水平无统计学差异。③左卡尼汀组低密度脂蛋白较对照组下降，有统计学差异。④进行亚组分析发现：左卡尼汀使用时间大于24周，血总胆固醇水平较对照组有明显降低，具有统计学差异；血甘油三酯水平较对照组无统计学差异。伴高脂血症亚组进行分析，未发现组间总胆固醇和甘油三酯有统计学差异。 [结论] 血透患者应用左卡尼汀对血脂代谢有一定积极影响，且可能存在一定的时间效应。

Abstract: Background. The study aimed to assess the effects of L-Carnitine supplementation on lipid profile in maintenance hemodialysis patients with meta-analytical techniques. Methods. A literature search was performed for randomized trials comparing maintenance hemodialysis patients from L-Carnitine protocol versus placebo. The following outcomes were evaluated: Triglyceride(TG), total cholesterol(TC), low density lipoprotein(LDL), high density lipoproteins(HDL). Results. （1）Nine comparative studies of 259 patients matched the inclusion criteria,134 for L-Carnitine protocol and 125 for placebo protocol.The follow-up time was 12 weeks to 6 months. （2）Patients treated with L-Carnitine protocol showed a tendency of lower TC and a significantly lower LDL, but no difference in TG and HDL. However, subgroup analysis showed that patients treated with L-Carnitine more than 24weeks had lewer TC but no difference in TG, HDL, and LDL. Conclusion. The study found that application of L-carnitine had some positive impacts (reduce LDL levels) on lipid metabolism in hemodialysis patients. Moreover, the effect might be associated with time.