The effect of levocarnitine on vascular sclerosis and vascular endothelial function in patients with chronic renal failure on maintenance hemodialysis / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of maintenance hemodialysis (MHD) combined with levocarnitine on vascular sclerosis and vascular endothelial function in patients with chronic renal failure.Methods:Patients with chronic renal failure receiving MHD treatment admitted to Shanxian Central Hospital of Shandong Province from June 2019 to May 2020 were selected as the research object and they were divided into the observation group (53 cases) and the control group (49 cases) by the random number table method. The patients in the control group were treated with maintenance hemodialysis and the patients in the observation group were treated with combined levocarnitine on the basis of the control group. The levels of serum creatinine (SCr), blood urea nitrogen (BUN) and other renal function indicators were determined before and 6 months after the treatment. The levels of nuclear factor kappa B (NF-κB), tumor necrosis factor (TNF-α) and other microinflammatory indexes, and advanced oxidation protein products (AOPP), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and other oxidative response indexes were determined. The levels of endothelin-1 (ET-1), von Willebrand factor (vWF) and vascular reactive hyperemia index (RHI) were measured. Common carotid atherosclerosis β and pulse wave conduction velocity (PWV) were measured by color Doppler ultrasonography.Results:The levels of SCr, BUN in the two groups after treatment had no significant differences ( P>0.05). The levels of TNF-α and NF-κB in the observation group after treatment were lower than those in the control group: (20.22 ± 7.15) μg/L vs.(26.14 ± 5.96) μg/L, (6.10 ± 0.80) mg/L vs. (6.55 ± 1.10) mg/L, there were statistical differences ( P<0.05). The levels of AOPP, MDA in the observation group after treatment were lower than those in the control group and the level of GSH-PX was higher than that in the control group: (78.52 ± 17.41)μmol/L vs.(97.96 ± 18.29) μmol/L, (4.44 ± 1.02) μmol/L vs. (6.07 ± 1.26) μmol/L, (110.14 ± 22.17) mg/L vs.(90.63 ± 19.28) mg/L, there were statistical differences ( P<0.05). The levels of PWV, ET-1 and vWF in the observation group after treatment were lower than those in the control group and the RHI was higher than that in the control group: (7.29 ± 0.59) m/s vs. (7.89 ± 0.63) m/s, (44.15 ± 10.27) ng/L vs. (52.41 ± 12.74) ng/L, (30.26 ± 7.45) U/L vs. (35.71 ± 6.23) U/L, 1.54 ± 0.25 vs. 1.45 ± 0.20, there were statistical differences ( P<0.05). Conclusions:The combination of levocarnitine in the treatment of MHD can alleviate microinflammation, oxidative stress response and improve vascular endothelial function and arteriosclerosis.