尿毒症患者血清瘦素质量浓度与胃肠动力关系的探讨

Correlation of Serum Leptin and Gastrointestinal Movement in Uremic Patients

为探讨尿毒症患者血清瘦素水平与胃肠动力的关系 ,应用ELISA法检测了 2 6名尿毒症患者、2 0名健康自愿者的空腹血清瘦素质量浓度 ,应用胃肠测压技术检测上述人员的消化间期移行性复合运动 (migratingmotorcom plex,MMC) ,连续测定 2 40min。结果 :尿毒症患者空腹血清瘦素质量浓度升高 ,与正常对照相比有显著性差异〔(1 8.2 1± 1 2 .45 )比 (2 5 .81± 2 0 .0 4) μg/L ,P <0 .0 5〕 ;尿毒症患者存在MMC异常 ,表现为MMCⅢ期发生率明显减少为 1 9.2 % (5 /2 6) ,明显低于正常对照的 70 % (1 4/2 0 ,P <0 .0 1 ) ;大多数缺乏MMCⅢ期的尿毒症患者 (1 9/2 6,73 .1 % ) ,胃及小肠运动表现为不规则的收缩活动 ,即“Ⅰ期—Ⅱ期—I期”。提示 :尿毒症患者存在有高瘦素血症和MMC异常 。

To explore the correlation of serum leptin level with gastrointestinal movement in uremic patients, the serum leptin level was detected by ELISA in 26 uremic patients and 20 healthy volunteers. The migrating motor complex (MMC) of all preceding ones were detected by applying gastrointestinal manometry technology. Mean serum leptin concentration was significantly higher in the uremia than that in the control ((18.21±12.45) vs (25.81±20.04) μg/L, P<0.05). There were 5 cases (5/26, 19.2%) having normal MMC Ⅲ phase in uremic patients, which was significantly lower than that in the normal ones (14/20,70%, P<0.01). The irregular gastrointestinal contracted movement, which was from MMC Ⅰ phase to Ⅱ phase return to I phase, was very frequent in most of the patients who were short of MMC Ⅲ phase. Hyperleptinemia and dysfunction of gastrointestinal movements exist in uremic patients. Hyperleptinemia may restrain MMC to a certain degree.