肺感染致多器官功能障碍综合征血清瘦素浓度的变化

Changes of serum leptin level in pulmonary infection-induced multiple organ dysfunction syndrome

目的检测肺部严重感染所致多器官功能障碍综合征(MODS)、急性心肌梗死(AMI)和心律失常(AR)等危重症患者血清中瘦素(Leptin)及相关因子水平的变化,探讨Leptin在MODS发病及诊断中的可能意义。方法采用放射免疫分析法测定Leptin、脂肪酸结合蛋白(FABP)、转铁蛋白(Ferr)以及白细胞介素1β(IL1β)水平,采用酶联免疫吸附法(ELISA)测定C反应蛋白(CRP)水平。结果与正常对照组相比,Leptin水平在MODS、AMI和AR组均明显增高(P均<0.01);CRP和IL1β水平在MODS、AMI和AR组均显著增高(P<0.05或P<0.01),以MODS组患者增高更明显(P均<0.05);FABP和Ferr在3组患者中也均有明显上升趋势,特别是在MODS组中上升更多,但统计学上差异无显著性。结论肺感染所致MODS患者血清中Leptin水平明显上升,伴有CRP和IL1β同时升高,Leptin可能在MODS的发生和转归中发挥一定作用。

Objective To determine serum levels of leptin and some related cytokines in severely ill patients, including severe pulmonary infection-induced multiple organ dysfunction syndrome (MODS), acute myocardial infarction (AMI) and arrhythmia (AR), and to explore the possible role of leptin in the pathogenesis and diagnosis of MODS. Methods Radioimmunoassay was used to determine leptin, fatty acid binding protein (FABP), transferrin (Ferr) and interleukin-1β (IL-1β), and enzyme-linked immuno- adsorbant assay (ELISA) was used to assess C reactive protein (CRP). Results Compared with normal individuals, leptin levels in MODS, AMI and AR patients increased significantly (all P<0.01). CRP and IL-1β levels also increased significantly in MODS, AMI and AR patients, but the changes were more marked (all P<0.05) in MODS patients than in the patients of other two diseases (both P<0.05). Though FABP and Ferr levels of patients in all the three groups of patients showed a trend toward increase, especially in MODS patients, there was no significant difference between them and normal individuals. Conclusion Serum leptin level increases significantly in pulmonary infection-induced MODS patients with a simultaneous increase of CRP and IL-1β levels, and the result suggests that leptin plays a possible role in the pathogenesis and prognosis of MODS.