维持性血液透析患者血清脂联素水平及影响因素的临床观察

Clinical observation on the serum adiponectin level and its influencing factors in maintenance hemodialysis patients

目的:观察维持性血液透析患者血清脂联素水平及相关影响因素。方法:选取弋矶山医院血液透析患者69例,收集患者一般临床资料,同时采用默克公司液体芯片技术检测患者血清的脂联素、PAI1、IL-6、MCP-1、TNFα、IL-1b等,并将患者的临床资料及前炎症因子与脂联素水平进行双变量相关性分析,得出相关因子进一步行多元线性回归分析。结果:(1)维持性血液透析患者脂联素水平与患者HDL水平呈正相关,r=0.294,P=0.021;脂联素水平与体质量、BMI呈负相关,r值分别为-0.457、-0.435;P值分别为0.000、0.000;维持性血液透析患者脂联素水平与炎症因子无相关性。(2)多元回归分析显示维持性血液透析患者脂联素水平主要影响因素有HDL、BMI。结论:HDL、BMI是维持性血液透析患者脂联素水平的主要影响因素,炎症因子可能不是维持性血液透析患者脂联素水平的影响因素,结果仍需大样本的验证。

Objective： To observe the serum adiponectin level and its influencing factors in patients undergoing maintenance hemodialysis. Methods： General clinical data were obtained from 69 cases undergone maintenance hemodialysis in our hospital. Merck＇ s liquid-extraction chip technique was used to detect adiponectin,plasminogen activator inhibitor-1（ PAI1）,interleukin 6（ IL-6）,monocyte chemotactic protein 1（ MCP-1）,tumor necrosis factor alfa（ TNFα） and IL-1 b. Bivariate correlation analysis was performed to analyze the partial correlation among the clinical data,proinflammatory factors and adiponectin level. Then the related factors were analyzed with multiple regression. Results： Adiponectin level was positively correlated with high density lipoprotein（ HDL） level in patients undergoing maintenance hemodialysis（ r = 0. 294,P = 0. 021）,and negatively with body weight and body mass index（ BMI）（ r =-0. 457,r =-0. 435; P = 0. 000,P = 0. 000,respectively）,yet had no relation with proinflammatory factors. Multiple regression analysis showed that the primary factors affecting adiponectin level in maintenance hemodialysis patients were associated with BMI and HDL. Conclusion： HDL and BMI are the major factors affecting the level of adiponectin in patients undergoing maintenance hemodialysis,whereas proinflammatory factors may not be the influencing role. The results remain further investigation by larger samples.