Sakurauchi Y, Matsumoto Y, Shinzato T, Takai I, Nakamura Y, Sato M, Nakai S, Miwa M, Morita H, Miwa T, Amano I, Maeda K
Aichi Clinic, Toyohashi, Japan.
Am J Kidney Dis. 1998 Aug;32(2):258-64. doi: 10.1053/ajkd.1998.v32.pm9708610.
Various muscle symptoms are well recognized among patients on maintenance hemodialysis. Carnitine deficiency may be an important factor of dialysis-associated muscle symptoms, whereas high-dose L-carnitine supplementation may result in unphysiologically high plasma levels of carnitine and carnitine esters. We studied the effect of low-dose L-carnitine treatment (500 mg/d) on muscle symptoms, plasma carnitine fractions, and lipid profiles in 30 periodically dialyzed patients with muscular weakness, fatigue, or cramps/aches. After 12 weeks of L-carnitine treatment, about two-thirds of patients had at least some improvement in muscular symptoms, whereas carnitine fractions were normal or slightly above normal ranges, but lipid profiles showed no demonstrable changes. This study also showed the correlation between plasma-free carnitine deficiency and months on dialysis. These results suggest that prolonged low-dose L-carnitine treatment can improve dialysis-associated muscle symptoms by restoring carnitine tissue levels and washing out acyl moieties.
维持性血液透析患者中各种肌肉症状已得到充分认识。肉碱缺乏可能是透析相关肌肉症状的一个重要因素，而高剂量补充左旋肉碱可能会导致血浆中肉碱和肉碱酯水平高于生理范围。我们研究了低剂量左旋肉碱治疗（500毫克/天）对30例周期性透析的肌肉无力、疲劳或痉挛/疼痛患者的肌肉症状、血浆肉碱组分和血脂谱的影响。经过12周的左旋肉碱治疗，约三分之二的患者肌肉症状至少有一定改善，而肉碱组分正常或略高于正常范围，但血脂谱无明显变化。这项研究还显示了血浆游离肉碱缺乏与透析月数之间的相关性。这些结果表明，长期低剂量左旋肉碱治疗可通过恢复组织肉碱水平和清除酰基部分来改善透析相关肌肉症状。
