腹膜透析病人血浆瘦素、炎症因子与营养关系的研究  

An Analysis for the Relationship Between Leptin,Inflammation and the Nutrition Status in Peritoneal Dialysis Patients

作　　者：关欣[1] 郑红光[1] 

机构地区：[1]沈阳军区总医院肾内科,辽宁沈阳110016

出　　处：《锦州医学院学报》2005年第3期37-39,共3页Journal of Jinzhou Medical College

摘　　要：目的　探讨腹透患者血浆瘦素、炎症因子水平与营养状况的关系。方法　2 6例腹透患者和2 6例健康者为研究对象。采用ELISA法测血浆瘦素、腹透液中瘦素水平,用免疫散射比浊法测C反应蛋白(CRP) ,用免疫化学发光分析法测白介素IL - 6和肿瘤坏死因子TNF -α水平,同时检测胰岛素、血清白蛋白(ALB)水平,并用SGA法评估营养状况。结果　①腹透(CAPD)患者血浆瘦素(Leptin)、腹透液中瘦素和胰岛素水平明显高于正常人(P <0 . 0 1)。②腹透患者血浆中炎症因子CRP ,IL - 6和TNF -α水平明显高于正常人(P <0 0 1)。③腹透患者的营养状况较正常人差,ALB水平明显低于正常人(P <0 . 0 1)。④相关分析:腹透患者血浆瘦素与腹透液中瘦素、胰岛素水平间均呈明显正相关(P <0 . 0 1) ,而血浆瘦素与血清ALB、CRP、IL - 6及TNF -α之间均未见明显相关(P >0. 0 5 )。CRP、IL - 6、TNF -α与ALB之间均呈显著负相关(P <0 .0 1)。CRP与IL -6、TNF -α之间以及IL - 6与TNF -α之间呈明显正相关(P <0. 0 1)。结论　CAPD患者血浆瘦素、炎症因子均与营养状况关系密切。Objective To study the relationship of serum leptin and inflammation with nutrition status in continuous ambulatory peritoneal dialysis (CAPD)patients. Methods 26 CAPD patients and 26 healthy controls were enrolled in the study.Leptin was measured by ELISA,C reactive protein(CRP)by transmission turbidmetry and interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)by immunofluorescence. These patients were classified to three nutritional categories based on SGA normalnutrition, mild-to-moderate malnutrition, and severe malnutrition. Results CAPD group had significantly higher serum leptin,peritoneal dialysis fluid leptin, insulin,CRP,IL-6 and TNF-α,lower serum albumn(ALB) than the control group.Serum leptin was significantly positive correlation with peritoneal dialysis fluid leptin and insulin.Serum leptin was no correlation with ALB,CRP,IL-6 and TNF-α.IL-6 was significantly positive correlation with TNF-α. Conclusions Serum leptin and inflammation are closely related to the occurrece of malnutrition in CAPD.

关 键 词：CAPD 瘦素 炎症因子 营养 

分 类 号：R589.4[医药卫生—内分泌]