慢性肾衰病人血清瘦素水平的变化及其影响因素

Changes and influent factors of serum leptin Ievels in patients with chronic renal failure

【摘要】目的 了解慢性肾衰(CRF)病人血清瘦素水平的变化及其影响因素,包括代谢性酸中毒、血透、营养状况等。方法 以放免法测定70名正常人与70名CRF病人(其中非透析CRF病人46名,血透病人24名)血清瘦素水平,观察其变化及其与血浆HCO3一、肾功能、血清总蛋白、白蛋白、血脂等之间的关系。结果 正常对照组血清瘦素浓度为 6.99士 5.78ng/ml,与 BMI呈明显正相关,且女性瘦素浓度明显高于男性(P<0.005)。CRF病人血清瘦素浓度为12.95上13.27ng/ml,较正常人明显升高(P<0.005),亦与 BMI呈明显正相关,且女性浓度明显高于男性(P<0、005)。其中非透析病人血清瘦素浓度为13.51 13.82nyml,经纠正酸中毒治疗后其水平明显升高至22.96 f 27.33nyml(P<0.0);血透病人透析前、后血清瘦素浓度分别为1176土1219ng/ml及1223上14.50ng/ml,两者无显著差异(P>0 05)。CRF病人血清瘦素浓度与血浆 HCO3一、血清总蛋白、白蛋白呈明显正相关。结论 本组 CRF病人血清瘦素水平明显高于正常人;代谢性酸中毒可使CRF病人血清瘦素水平下降;本组血透病人透析后应素水平无明显变化,可能与代谢性酸中毒纠正后瘦素水平下降“抵消”了血透对瘦素的清除作用有关;CRF病人的营养状况可能与血清瘦素水平变化有关。

Objective To examine serum leptin levels(SL) in chronic renal failure (CRF) patients (both non - hemodialysis and hemodialysis patients) and its influent factors including metabolic acidosis, hemodialy-sis, nutritional status. Methods 70 healthy controls and 70 CRF patients (46 non- hemodialysis patients and 24 hemodialysis patients) were studied, and SL were determined by radiommunoassay. The relationship among SL and plasma HCO3 , renal function, serum protein, blood lipid Ievels were analysed. Results SL in normai controls were 6. 99 ± 5.78ng/ml, and related to body mass index (BMI) positively. SL in CRF patients were 12.95 ± 13.27ng/ml, which were significantly higher than in normal controls (P<0. 005). SL in females was higher than that in males in both normai controls ( P < 0. 005 ) and CRF patients ( P < 0. 005). SL in non - hemodialysis CRF patients before and after correction of metabolic acidosis were 13. 51 ± 13.82ng/ml VS 22.96 ± 27.33ng/ml( P < 0.01), respectively. SL in CRF hemodialysis patients before and after hemodialysis were 11.76 ± 12.19ng/ml VS 12.23 ± 14.50ng/ml (P>0.05), respectively. SL in CRF patients were positively correlated to plasma HCO3- , serum total protein and albumin levels. Conclusions SL in CRF patients were significantly higher than that in normai controls and SL may probably be reduced by metabolic acidosis. No significant change was found in CRF patients before and after hemodialysis. SL may also be related to plasma HCO3- and albumin Ievels in CRF patients.