维持性血透患者高抵抗素血症及其意义探讨

A elevated level of plasma reistin and microinflammation in maintenance hemodialysis patient

目的:观察维持性血透患者血浆抵抗素(Resistin)水平,探讨与微炎症状态的关系。方法:选择我院肾内科病情稳定的维特性血透患者73例,健康志愿者20例,ELISA法测研究对象的空腹IL-6、FNF-α、血抵抗素水平与免疫比浊法测定CRP,并测定血脂、白蛋白、空腹血糖及胰岛素水平,采用空腹血糖×胰岛素/22.5计算胰岛素抵抗(IR)值。结果:维持性血透患者血浆抵抗素水平较正常组明显升高,为(40.15±22.46)ug/L vs(11.78±6.29)ug/L(P<0.01),同时CRP、IL-6、FNF-α也较正常组明显升高,分别为(4.56±1.46)mg/L vs (2.10±0.67)mg/L(P<0.01),(90.19±32.04)ng/L vs (49.30±28.12)mg/L(P<0.01),(115.16±90.35)mg/L vs(48.21±36.54)ng/L(P<0.01),Spearmen相关分析显示抵抗素与TG、CRP呈正相关(r=0.271,0.246,P<0.05)。结论:维持性血透患者抵抗素水平明显升高且与微炎症状态有关,抵抗素可能在ESRD患者心血管损伤中起作用。

Objective：To investigate plasma resistin level in maintenance hemodialysis（ MHD）patients and explore its relationship with microinflammation. Methods：73 patients with MHD and 20 healthy volunteers were involved in this study . Plasma concentrations of IL-6, TNF-α ,resistin were measured by enzyme linked immunoassay（ELISA）. The serum levels of high sensitivity C-reactive protein （CRP）,triglyceride, cholesterol, albumin, glucose and insulin were also detected. The homeostasis model assessment index（HOMA-R） was calculated as an estimate of insulin resistance from the fasting glucose and insulin. Results：The plasma level of resistin in MHD was significantly increased compared with healthy controls（40.15 ± 22.46 vs 11.78±6.29 ug/L,P〈0.01）. The levels of CRP,IL-6,TNF-α were also significantly higher in MHD as compared with healthy control（4.56 ± 1.46 vs 2.10 ± 0.67 mg/L,P 〈 0.01 ;90.19 ± 32.04 vs 49.30 ± 28.12 ng/L P 〈 0.01 ; 115.16 ± 90.35 vs 48.21 ±36.54 ng/L P 〈 0.01;respectively）. A significant positive correlation was observed between the serum resistin and CRP （r=0.246,P〈 0.05）.However plasma resistin levels were not correlated with the levels of IR. Conclusions：The level of resistin in MHD is significant higher compared with healthy controls and correlated with microinflammation. Resistin is probably playing important effect on the cardiovascular injury of end stage renal disease.