不同血液净化慢性肾功能衰竭患者血清瘦素与营养关系的研究  

The relationship between leptin and nutrition status in patients with chronic renal failure undergoing different ways of blood purification

作　　者：徐旭东[1] 胡屏[1] 汪年松[2] 张冉[1] 余华[1] 姜珊[1] 

机构地区：[1]上海交通大学附属瑞金医院集团闵行医院肾内科,上海201100 [2]上海交通大学附属上海市第六人民医院肾内科,上海200233

出　　处：《徐州医学院学报》2008年第2期85-88,共4页Acta Academiae Medicinae Xuzhou

基　　金：上海市闵行区科技发展基金(2005-23)

摘　　要：目的探讨不同血液净化方式对慢性肾功能衰竭(CRF)患者血清瘦素(leptin)与营养状态的影响。方法选择CRF患者非透析治疗(NHD)、血液透析(HD)、血液透析滤过(HDF)、腹膜透析(PD)各40例及正常对照40例,应用放射免疫分析法测定血清中瘦素水平,常规生化方法测定血清尿素氮(BUN)、肌酐(Cr)、白蛋白(Alb)、总胆固醇(TC)和血红蛋白(Hb),计算体重指数(BMI,kg/m2)。结果CRF患者的血清瘦素浓度明显高于正常对照组(P<0.01);NHD、HD和PD对血清瘦素水平无明显影响,HDF可以明显降低CRF患者血清瘦素水平(P<0.05)。CRF患者血清瘦素浓度与BMI呈明显正相关(P<0.05),与BUN、Cr、Alb、TC、Hb相关性无统计学意义(P>0.05)。结论HDF可以较好地清除血清瘦素,改善CRF患者营养状态。Objective To investigate the relationship of serum leptin level with nutrition status against different ways of blood purification in patients with chronic renal failure（CRF）. Methods One hundred and sixty patients with CRF were divided into 4 groups （ n = 40 each） ： NHD group （ non - hemodialysis）, HD group （ hemodialysis）, HDF group （hemofiltration） and PD group（ peritonial dialysis）. Another forty healthy subjects were enrolled to form a normal control group. Serum leptin level was detected by radioimmunoassay. Blood tests were made to meaure Cr, BUN, Alb, Hb and TC. Their body mass index （BMI） was calculated. Results The serum leptin level in CRF patients was obviously higher than that in the healthy control（ P 〈0.01 ）. HDF could lower the leptin level in CRF patients, but NHD, HD and PD had little effect in this respect. Besides, the leptin level was positively correlated with BMI （ P 〈 0.01 ）, but not with Cr, BUN, Alb, TC or Hb（ P 〉0.05）. Conclusions HDF can eliminate leptin preferably , so as to improve the patient＇s nutritional status.

关 键 词：慢性肾功能衰竭 血液透析滤过 腹膜透析 营养状态 瘦素 

分 类 号：R692.5[医药卫生—泌尿科学]