不同血液净化方法对Leptin的清除比较

Comparison of serum Leptin clearance with different blood purification

目的 :探讨不同血液净化方法对血 L eptin的清除效果。方法 :选 31例因慢性肾衰竭而进行维持性血液透析的患者进行研究。于 31例患者单次普通血液透析前后 ,其中 1 2例于单次血液透析滤过前后、8例于单次血液吸附治疗前后分别采静脉血 ,采用放射免疫分析法测定血清 L eptin水平。结果 :慢性肾衰竭血液透析患者常规透析前后血 L eptin水平无显著差异〔(1 1 .82 0± 5 .5 0 7) μg/ L 比 (1 2 .2 5 5± 5 .1 72 ) μg/ L,P>0 .0 5〕。单次血液透析滤过和血液吸附治疗可分别降低血 L eptin(2 9.0 7± 8.5 6 ) %和 (4 0 .2 9± 8.33) % ,两种治疗方法清除效果比较有显著性差异 (P=0 .0 0 1 )。结论 :常规血液透析对慢性肾衰竭血液透析患者体内高 L eptin血症无影响 ;单次血液透析滤过和血液吸附治疗均可降低血 L eptin水平 ;血液吸附治疗对血 L eptin的清除效果优于血液透析滤过治疗。

Objective: To compare the serum Leptin clearance efficiency with different blood purification treatment . Methods: Thirtyone chronic endstage renal failure hemodialysis (HD) patients 〔 16 men , 15 women , mean age (54 0±11 0)years〕 were enrolled into the study. All the patients were treated with routine hemodialysis, the serum Leptin levels were examined before and after HD. Then they were divided into two groups, one was to be treated with hemodiafiltration (12 patients), and the other was to be treated with blood adsorption (8 patients). The same serum Leptin levels were examined before and after treatment. Serum Leptin concentration was detected by radioimmunoassay (RIA). Results: The concentration of serum Leptin was not significantly decreased after routine hemodialysis in HD patients 〔(11 820±5 507)μg/L vs. (12 255±5 172)μg/L, P >0 05 〕. Leptin concentrations after hemodiafiltration and blood adsorption therapy were decreased to the levels of (29 07±8 56) percent and (40 29±8 33) percent respectively, and their curative effect was significantly different ( P =0 001 ). Conclusion: Routine hemodialysis can influence serum Leptin levels in HD patients. Hemodiafiltration and blood adsorption therapy can lower serum Leptin levels. Blood adsorption therapy is better than hemodiafiltration in the clearence of serum Leptin.