血清脂联素在急性肾损伤患者中的变化及其与预后的关系

Changes of serum adiponectin level in patients with acute kidney injury and its relationship with prognosis

目的:探讨血清脂联素(ADPN)在急性肾损伤(AKI)患者中的变化及其与预后的关系。方法:选取AKI患者108例为AKI组,随机选取健康体检者30例为对照组,比较两组脂联素水平。根据病因、分期对AKI患者分组,比较各组间ADPN水平;比较不同预后患者间血清脂联素水平的差异,并绘制ADPN水平与预后的治愈曲线,分析两者的关系。结果:AKI患者血清ADPN水平18.30±10.55 mg/L,明显高于对照组的3.25±2.15 mg/L,差异有统计学意义(P<0.05)。不同病因及不同分期AKI患者血APDN水平比较,差异无统计学意义(P>0.05)。AKI患者第一次随访时血肌酐水平373.66±295.36μmol/L,明显低于入院时605.08±332.93μmol/L;ADPN水平为21.78±10.53 mg/L,高于入院时18.30±10.54 mg/L,差异均有统计学意义(P<0.05)。出院3个月后,血清ADPN水平治愈组24.53±9.52 mg/L,缓解组23.66±10.74 mg/L,未愈组15.52±9.30 mg/L,治愈组和缓解组高于未愈组,差异均有统计学意义(P<0.05)。Pearson相关分析显示,AKI患者ADPN水平与白蛋白、球蛋白、血糖、血钾、血沉、年龄等无相关性,与血红蛋白、体质量指数、C反应蛋白呈负相关(P<0.05)。Kaplan-Meier治愈曲线分析发现,高ADPN水平患者治愈率高于低ADPN水平患者(P<0.05)。结论:AKI患者血清ADPN水平升高,ADPN水平与病因及分期无关,高ADPN水平患者预后相对较好,可能与ADPN抑制炎症反应的作用有关。

Objective:To investigate the changes of serum adiponectin(ADPN)in patients with acute kidney injury(AKI)and its relationship with prognosis.Methods:A total of 108 patients with AKI were selected,and 30 healthy subjects were randomly selected as the control group.The levels of adiponectin and biochemical indexes were compared between the two groups.Grouping according to the etiology and staging in patients with AKI,and comparison between groups of ADPN level were made;Compare serum adiponectin levels among patients with different prognosis,and draw ADPN level and the prognosis of recovery curve,analyze its possible relationship.Results:Serum ADPN of AKI patients was significantly higher than that of control group(P<0.05).There was no significant difference in APDN levels among AKI patients with different etiology and stages.After treatment,serum creatinine and adiponectin levels were significantly different from those at admission(P<0.05).The patients were followed up 3 months after discharge.The results showed that the level of serum ADPN was the highest in the cured group,followed by the remission group,and there was a significant difference between the cured group and the uncured group(P<0.05).Although there was a difference between the remission group and the cure group,there was no statistical significance.Pearson correlation analysis showed that ADPN level in AKI patients was not correlated with albumin,globulin,blood glucose,serum potassium,erythrocyte sedimentation rate,age,etc.,but was negatively correlated with hemoglobin,body mass index,C-reactive protein.Kaplan-Meier recovery curves of patients with different ADPN levels were plotted,and it was found that patients with high ADPN levels had a higher recovery rate than patients with low ADPN levels.Conclusion:The increase of serum ADPN level in AKI patients is independent of etiology and stage,and the prognosis of patients with high ADPN level is relatively good,which may be related to the inhibition of inflammatory response by high ADPN level.However,the exact mechanism of action between AKI and ADPN still needs further study.