肝硬化患者肌肉痉挛:左旋肉碱

StephenW

August 14, 2015

L-carnitine for Muscle Cramps in Patients with Cirrhosis

Atif Zaman, MD, MPH Reviewing Nakanishi H et al., Clin Gastroenterol Hepatol 2015 Aug 13:1540

Preliminary data show significant reduction of cramps in 88% of patients after 8 weeks of therapy.

Muscle cramps occur commonly in patients with cirrhosis and are associated with diminished quality of life. They are typically described as involuntary painful contractions of muscle groups during rest or sleep that last for seconds or minutes and are self-limiting. The mechanism is unclear but includes impairment in energy metabolism, derangement in electrolyte and volume status, and possibly nerve dysfunction. Carnitine deficiency might affect energy metabolism, thereby causing muscle cramps.

In an uncontrolled study, investigators assessed the efficacy of an 8-week course of L-carnitine (300 mg, 3 or 4 times daily) in 42 consecutive patients with cirrhosis and symptoms of muscle cramps occurring more than twice during the preceding 4 weeks. Patients reported the frequency and duration of cramps in questionnaires and the severity of cramps using a visual analog scale (VAS).

After 8 weeks of therapy, the mean frequency of muscle cramps was significantly reduced from 5.1 (standard deviation, 5.9) to 1.7 (SD, 3.0) times per week. Cramps were reduced in 88.1% of patients and completely eliminated in 28.6%. The VAS score (evaluated in 31 patients) at baseline was 69.9 (SD, 22.5) and was significantly reduced to 26.2 (SD, 29.1) after 8 weeks. Patients receiving the higher daily dose of L-carnitine had a significantly higher rate of muscle cramp elimination (43.5% vs. 10.5%) and lower VAS scores (P=0.003).

Comment

Although this is a small uncontrolled pilot study, the results are compelling; patients with cirrhosis experienced improvement not only in the frequency but also in the intensity of muscle cramps, and a dose-response relationship was evident. Larger placebo-controlled studies are needed, but until then, a trial of L-carnitine would be a reasonable option in clinical care of patients with debilitating muscle cramps.

Editor Disclosures at Time of Publication

Disclosures for Atif Zaman, MD, MPH at time of publication

Nothing to disclose

2015年8月14日

左旋肉碱肌肉痉挛肝硬化患者

与Atif扎曼博士，公共卫生硕士回顾中西H等人，Clin Gastroenterol肝脏病2015年8月13日：1540

初步数据显示在88％的患者显著减少痉挛8周的治疗后。

通常发生在肝硬化患者肌肉痉挛和生活质量的下降有关。它们通常被描述为肌肉群在休息或睡眠不自主的痛苦收缩，持续数秒或数分钟，并是自限性。的机理还不清楚，但包括在能量代谢障碍，紊乱在电解质和卷状态，以及可能的神经功能障碍。肉碱缺乏症会影响能量代谢，从而导致肌肉痉挛。

在不受控制的研究中，研究者评估L-肉毒碱的一个8周的课程的疗效（300毫克，3或4次每日）在之前的4周连续42肝硬化患者和发生两次以上肌肉痉挛的症状。患者报告抽筋的问卷调查的频率和持续时间，并使用视觉模拟评分法（VAS）痉挛的严重程度。

8周治疗后，肌肉痉挛的平均频率被显著从5.1（标准偏差，5.9）减少到1.7（SD，3.0）每周次。痉挛均减少的患者88.1％和28.6％完全消除。 VAS评分（31例计算）的基准是69.9（SD，22.5）和8周后显著减少至26.2（SD，29.1）。接受更高的每日剂量左旋肉碱患者有显著率较高的肌肉痉挛消除（43.5％对10.5％）和较低的VAS评分（P = 0.003）。

评论

虽然这是一个很小的不受控制的试验研究，结果是令人信服的;肝硬化患者经历改善不仅在频率，而且在肌肉痉挛的强度，并以剂量​​ - 反应关系是显而易见的。需要在更大的安慰剂对照研究，但在那之前，左旋肉碱的审判将在临床护理患者一个合理的选择衰弱的肌肉痉挛。

在发布时披露编辑

在发布时披露与Atif扎曼，MD，MPH

没有透露

llau_lhf

没看懂？

csfluke

左旋肉碱不是有两年吹的最火的减肥的东西吗，号称可以加快能量代谢

StephenW

回复 csfluke 的帖子

左旋肉碱是一种物质，可以帮助人体将脂肪转化成能量。你的身体制造它在肝脏和肾脏，并将其存储在骨骼肌，心脏，脑，和精子。

减肥的东西吗? 没有科学证据.

StephenW

回复 llau_lhf 的帖子

肝硬化患者通常发生肌肉痉挛, 造成生活质量下降.
8周的左旋肉碱治疗后,初步数据显示在88％的患者显著减少痉挛.

生命满希望

csfluke 发表于 2015-8-16 12:23
左旋肉碱不是有两年吹的最火的减肥的东西吗，号称可以加快能量代谢

左旋肉碱确实可以加快脂肪代谢转化能量，就算正常人适当补充左旋肉碱有益无害，婴幼儿配方奶粉也有添加！

llau_lhf

回复 StephenW 的帖子

谢谢，搜了下，市面上应用主要是减肥，我倒是要增肥，那就算了。

csfluke

回复 生命满希望 的帖子

当时宣传的火的时候我有查过资料，说这个就和营养一样，只要不缺，过量补充是做无用功，婴幼儿是因为身体机能还不完善，需要适当补充，有害倒好像没有，但是这东西记得卖的不便宜，有益无害还是谈不上吧，对正常人来说充其量说是无害无益。