终末期肾脏病患者血清抵抗素水平的变化及意义  

Levels of serum resistin in patients with end stage renal disease

作　　者：张桦[1] 贾宁[1] 郭军利[1] 张慧涛[1] 汪悠悠[1] 

机构地区：[1]中山大学附属第五医院肾内科,广东珠海519000

出　　处：《中华临床医师杂志（电子版）》2008年第11期10-13,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省珠海市科技计划项目(PC20052029);广东省科技厅科技计划项目(2008B030301084)

摘　　要：目的检测终末期肾脏病(ESRD)透析和非透析患者血清抵抗素、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)及血清白蛋白、血脂、肾功能水平,探讨ESRD患者血清抵抗素水平的变化及与各影响因素的关系。方法选择ESRD患者60例,分为3组:肾衰非透析组(18例)、血液透析组(22例)和腹膜透析组(20例),另设正常对照组(20例)。用ELISA方法检测血清抵抗素、TNF-α和hs-CRP,同时常规测定血肌酐(SCr)、血清白蛋白、血总胆固醇和甘油三酯。比较各组间的差别。结果(1)患者血清抵抗素水平在肾衰非透析组[(9.95±2.65)mg/L]、血液透析组[(10.52±4.77)mg/L]和腹膜透析组[(10.90±2.55)mg/L]均显著升高,与对照组[(4.60±1.47)mg/L]相比,差异有统计学意义(P<0.01),但三组之间比较差异无统计学意义(P>0.05)。(2)ESRD患者血清抵抗素水平与TNF-α(r=0.539)、hs-CRP(r=0.406)、SCr(r=0.340)呈正相关(P<0.01),与肾小球滤过率(GFR)呈负相关(r=-0.807,P<0.01)。结论在终末期肾脏病,无论血液透析、腹膜透析还是非透析患者,其血清抵抗素水平均明显升高,并与TNF-α、CRP、GFR等因素有关。抵抗素可能对ESRD患者的亚临床炎症起一定作用。Objective To examine the levels of serum resistin in patients with end stage renal disease（ESRD） ,and identify the relationship between serum resistin and tumor necrosis factor（TNF）-α, high sensitivity C-reactive protein（hs-CRP） ,albumin（ALB） ,blood lipid and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were invovled in this study. The patients were divided into three groups ： patients with chronic renal failure without dialysis （ CRF, 18 cases ） , patients with hemodialysis （HD,22 eases） and patients with peritoneal dialysis（PD,20 cases）. The levels of serum resistin,TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables between the three groups were evaluated. Results The levels of serum resistin were significantly higher in CRF patients [（9.95±2. 65 ） mg/L], HD patients[（10.52±4. 77）mg/L] and PD patients[（10.90±2. 55）mg/L] than those in healthy subjects [（4.60±1.47） mg/L ] （P 〈 0. 01 ）, and resistin concentrations were similar in CRF patients, HD patients and PD patients（ P 〉 0. 05 ）. Serum resistin levels in ESRD patients were positively related to serum TNF-α （r=0. 539 ）, hs-CRP（ r = 0. 406 ） and SCr（ r = 0. 340 ） （ P 〈 0. 01 ）, and negatively related to GFR （ r = - 0. 807, P 〈0.01）. Conclusions The level of serum resistin was markedly increased in patients with ESRD. In addition,the study demonstrates the relationship between serum resistin and TNF-α, hs-CRP level and suggestes that resistin might play a role in the sub-clinical inflammation associated with ESRD.

关 键 词：肾功能衰竭 慢性 血液透析 腹膜透析 持续不卧床 抵抗素 炎症 

分 类 号：R692.5[医药卫生—泌尿科学] R446.6[医药卫生—外科学]