Lipid-lowering Effficacy Of L-carnitine Oral Solution For Children With Nephrotic Syndrome

Objectives: To providing a new idea for the treatment of hyperlipidemia in children with nephrotic syndrome by researching the lipid-lowering efficacy and safety of L-carnitine oral solution for children with nephrotic syndrome(NS);at the same time,we further discuss the role of L-carnitine oral solution in blood lipid metabolism and its mechanism of lipid-lowering.Methods: 149 children with nephrotic syndrome who were admitted into our hospital from May 2015 to October 2017 were selected and divided into two groups by the method of randomized digital table.60 cases in control group(group B)were treated with prednisone and other medicines,89 cases in experimental group(group A)were treated with L-carnitine oral solution(100 mg/(kg?d)orally,the maximum dose is no more than 3g a day)and the same therapy as control group.Respectively,before the treatment(A0,B0),one month after treatment(A1,B1),two months after treatment(A2,B2)blood lipids(TC,TG,HDL-C,LDL-C,Apo-B,Lp(a)),plasma albumin(ALB),urine protein(24HUP),liver function(ALT?AST),kidney function(BUN,SCr)were detected and compared by two independent samples t test.At the same time the treatment efficiency and adverse reactions of L-carnitine oral solution were observed and recorded in two groups after one month of treatment.Results: 1.Before treatment,there were no significant difference of gender?age?course of disease?all laboratory test index(Including serum lipid,albumin,the quantification of 24 hours urine protein,liver function,kidney function)in two groups(P>0.05).2.After one month of treatment,the total effective rate of group A1(93.26%)was significantly higher than that of group B1(78.33%),and the difference was statistically significant(P<0.05).TC,LDL-C,Lp(a): in group A1 and group B1 were lower than that before the treatment(group A0,group B0),and group A1 was lower than group B1,the differences were statistically significant(P<0.05).TG and Apo-B in group A1 were significantly lower than that in group A0,the difference was statistically significant(P < 0.05),but in group B1 there was no statistically significant difference compared with that before the treatment(P > 0.05).TG and Apo-B decreased more obvious in group A1 than B1 after one month of therapy,the difference was statistically significant(P < 0.05).ALB in the group A1 and group B1 both increased when compared with group A0 and group B0,the difference was statistically significant(P<0.05),but the difference between group A1 and group B1 was not statistically significant(P>0.05).24 HUP in group A1 and group B1 both decreased when compared with group A0 and group B0,the differences were statistically significant(P<0.05),but the differences were not statistically significant(P>0.05)when group A1 compared with group B1.No significant changes in HDL-C after one month of treatment(P>0.05).3?After two months of treatment,TC,TG,LDL-C,Apo-B,Lp(a)in group A2 and group B2 both decreased compared with group A1 and group B1,and the above indexes in group A2 was significantly lower than that in group B2,the differences were statistically significant(P<0.05).ALB in group A2 and group B2 both increased compared with that in group A1 and group B1,and ALB in group A2 was significantly higher than that in group B2,the difference was statistically significant(P<0.05).24 HUP in group A2 and group B2 both decreased compared with that in group A1 and group B1,but there were no significant differences between group A2 and B2(P>0.05).There was still no significant change in HDL-C after two months of treatment(P>0.05).4?Liver and kidney functions: There were no statistically significant differences between two groups before and after treatment(P>0.05),that is,the liver and kidney functions in both groups was not significantly changed before and after treatment.Conclusion: 1?After one month of treatment,the effective rate of lipid-lowering in group A1 L-carnitine oral solution used was significantly higher than that of group B1.And after one month of treatment,all the above serum lipid parameters except for HDL-C and 24-hour urine protein in group A1 appeared to drop,and all the indexes in group A1 decreased significantly more than group B1;Albumin in group A1 was increased compared with that in group A0 and albumin in group A1 increased more obvious than that in group B1.However,after one month of treatment,there were only partial serum lipid parameters in group B1 decreased significantly.2?After two months of treatment,the lipid-lowering efficacy ingroup A2 was more better than group B2 and group A1,so L-carnitine oral solution had good effect on lipid-lowering in children with NS.L-carnitine oral solution could got a better curative efficiency used two months than that used one month.3 ? There was no significant change in liver and kidney function before and after treatment in two group,no adverse reaction found in this study.In conclusion,L-carnitine oral solution was not only effective in lipid-lowering but also had no obvious toxicity in children with nephrptic syndrome,so it is worth to be used for children with nephrotic syndrome clinically.