重组人促红细胞生成素对慢性肾衰竭患者血清瘦素水平的影响

Influence of Recombinant Human Erythropoietin on Serum Leptin Level in Patients with Chronic Renal Failure

【目的】观察应用重组人促红细胞生成素对慢性终末期肾衰竭维持性血液透析患者血清瘦素的影响。【方法】实验组:20例慢性终末期肾衰竭维持性血液透析患者,常规透析后皮下注射重组人促红细胞生成素,3000U/次,2～3次/周,时间3月,口服多糖铁及叶酸辅助治疗;对照组:15例慢性终末期肾衰竭维持性血液透析患者,常规透析未接受促红细胞生成素治疗,其他治疗同实验组。治疗前后测定所有患者的血常规、体质量指数(BMI)和血清瘦素水平等。【结果】①实验组治疗后血红蛋白从(82.2±4.2)g/L上升到(94.6±4.4)g/L(P<0.001),红细胞压积从(29.2±1.7)%上升到(34.1±1.8)%(P<0.001),对照组治疗前后血常规差异无显著性(P>0.05);②实验组治疗后血清瘦素水平从(11.8±4.9)ng/mL降低到(8.9±3.5)ng/mL(r=0.614,P<0.001),对照组治疗前后血瘦素水平差异无显著性(P>0.05);③实验组治疗前血瘦素与BMI呈正相关(P<0.001),治疗后两者相关性消失(P>0.05),对照组治疗前后血瘦素与BMI分别呈正相关(P<0.001)。【结论】①重组人促红细胞生成素治疗可降低血液透析病人体内的高瘦素水平;②血液透析病人血瘦素与BMI呈正相关,但重组人促红细胞生成素治疗可使两者相关性消失。

[Objective] To observe the influence of recombinant human erythropoietin (rHuEPO) on serum leptin level in hemodialysis (HD) patients with end-stage chronic renal failure.[Methods](1) EPO group: 20 HD patients were enrolled into this study and were administered with rHuEPO subcutaneously to all patients post-dialysis, 3 000 IU every time, 2 or 3 times weekly. In addition, polyferose and folic acid were taken orally by all patients. The therapy lasted for 3 months. Non-EPO group: 15 HD patients were involved in this study, they were treated as same as EPO group except rHuEPO administration. (2) Body mass index (BMI), blood hemoglobin (HGB) and serum leptin were examined pre-therapy and post-therapy in all patients. [Results] (1) HGB in HD patients of EPO group increased from (82.2±4.2) g/L to (94.6±4.4) g/L (P< 0.001), hematorrit of EPO group increased from (29.2±1.7) % to (34.1±1.8) % (P< 0.001), while the changes in non-EPO group were not significant (P >0.05). (2) Serum leptin levels of HD patients in EPO group decreased from (11.8±4.9) ng/ml to (8.9±3.5) ng/ml (P< 0.001), while the change in non-EPO group was not significant. (3) Leptin was positively correlated with BMI before EPO therapy in EPO group (?酌=0.614,P< 0.001), but the relationship disappeared after the therapy (P >0.05), while leptin was correlated with BMI before and after therapy respectively in non-EPO group. [Conclusion] (1) Therapy of rHuEPO can lower high serum leptin levels in HD patients. (2) Leptin was positively correlated with BMI in HD patients, and EPO therapy can make the relationship disappear.