终末期肾脏病患者血清脂联素水平及与炎症因子的相关性研究

Serum adiponectin levels and inflammatory markers in patients with end-stage renal disease

目的检测终末期肾脏病（ESRD）患者血清脂联素（ADPN）、肿瘤坏死因子-α（TNF—α）、超敏C反应蛋白（hs—CRP）及肾功能水平，探讨ESRD患者血清ADPN水平的变化及与炎症因子的关系。方法选择ESRD患者60例，分为3组：肾衰非透析组（18例）、血液透析组（22例）和腹膜透析组（20例）。另设健康对照组（20例）。用ELISA方法检测血清ADPN、TNF—α和hs—CRP。比较各组间的差别。结果ESRD患者血清ADPN水平在肾衰非透析组[（15．88±4．94）mg／L]、血液透析组[（14．26±4．54）mg／L]和腹膜透析组[（14．55±3．51）mg／L]均显著升高（与对照组[（4．95±2．19）mg／L]相比，P〈0．01），但非透析和透析各组之间的差异无统计学意义（P〉0．05）。ESRD患者的血清TNF—α和hs—CRP水平在透析和非透析各组亦显著升高（与对照组相比，P〈0．01），并且在透析患者显著高于非透析患者（P〈0．01）。ESRD患者的血清ADPN水平与TNF—α呈正相关（r≥0．478，P〈0．01），与肾小球滤过率呈负相关（r≥-0．582，P〈0．01）。结论ESRD患者的血清ADPN水平明显升高，并与TNF—α、肾小球滤过率等因素有关。

Objective To examine the levels of serum adiponectin （ADPN）in patients with end-stage renal disease （ESRD）, and identify the relationship between serum ADPN and tumor necrosis factor （TNF）-α, high sensitivity C-reactive protein （hs-CRP） and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were involved in this study. The patients were divided into three groups： patients with chronic renal failure （CRF, 18 cases）, patients with hemodia]ysis （HD,22 cases） and patients with peritoneal dialysis （ PD,20 eases）. The levels of serum ADPN, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables between the three groups were evaluated. Results The levels of serum ADPN, TNF-α and hs-CRP in CRF, HD and PD patients were significantly higher than those in control group （ P 〈0. 01 ）. Serum ADPN levels in ESRD patients were positive related to serum TNF-α（ r ≥ 0. 478, P 〈 0. 01 ）, and negative related to GFR （ r ≥ - 0. 582, P 〈 0. 01 ）. Conclusion The level of serum ADPN was markedly increased in patients with ESRD, and correlated with serum TNF-α level and.renal function.