慢性肾脏病患者血清脂肪细胞因子水平及其作用的研究  

The level and role of serum adipokines in patients with chronic kidney disease

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

机构地区：[1]中山大学附属第五医院肾内科,珠海519000

出　　处：《中国实用医药》2009年第30期3-5,共3页China Practical Medicine

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

摘　　要：目的检测慢性肾脏病(CKD)患者血清脂联素(ADPN)、抵抗素(Res)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)水平,探讨CKD患者血清脂肪细胞因子水平的变化及其作用。方法选择CKD患者104例,分为肾病组、肾炎组、肾衰非透析组、腹膜透析组和血液透析组。另设健康对照组。用ELISA方法检测上述各项指标,比较各组间的差别。结果①CKD患者血清ADPN水平在肾病组[(22.40±6.02)mg/L]、肾炎组[(12.41±4.01)mg/L]、肾衰非透析组[(15.88±4.94)mg/L]、腹膜透析组[(14.55±3.51)mg/L]和血液透析组[(14.26±4.54)mg/L]均显著升高(与对照组[(4.95±2.19)mg/L]相比,P<0.01),并以肾病组升高为著;②患者的血清Res水平在肾衰非透析组[(9.95±2.65)μg/L]、腹膜透析组[(10.9±2.55)μg/L]和血液透析组[(10.52±4.77)μg/L]均显著升高(与对照组[(4.60±1.47)μg/L]和肾病组[(5.80±2.16)μg/L]、肾炎组[(5.57±1.24)μg/L]患者相比,P<0.01);③CKD患者的血清ADPN水平与Res、尿蛋白量呈正相关(P<0.05),与血白蛋白水平呈负相关(P<0.01);血清Res水平与TNF-α、hs-CRP、血肌酐呈正相关(P<0.01),与肾小球滤过率呈负相关(P<0.01)。结论CKD患者的血清ADPN、Res水平显著升高,并与尿蛋白量、炎性因子和肾小球滤过率等因素有关。ADPN和Res在CKD患者动脉粥样硬化的启动和发展中可能起一定作用。Objective To examine the levels of serum adipokines in patients with chronic kidney disease（CKD）, and identify the relationship between serum adipokines and tumor necrosis factor （TNF）-α, high sensitivity C-reactive protein（ hs-CRP） and renal function. Methods 104 CKD patients and 20 normal healthy persons were involvled in this study. The patients were divided into five groups ： patients with nephrotic syndrome （NS）, non-nephrotic syndrome（ n-NS）, chronic renal failure （CRF）, peritoneal dialysis （PD）and hemodialysis （HD）. The levels of serum adiponeetin （ADPN） , resistin （ Res）, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables between the six groups were evaluated. Results （1）The levels of serum ADPN were signifieantly higher in group of NS[ （ 22.40±6. 02 ） mg/L], n-NS [ （ 12.41 ±4.01 ） mg/L], CRF[ （ 15.88 ±4. 94） mg/L] ,PD[ （ 14. 55 ±3.51 ） mg/L] and HD[ （ 14.26±4. 54） mg/L] patients than those in control group[ （4. 95 ±2. 19 ）mg/L1 （P 〈 0. 01 ） ; （2）The levels of serum Res were significantly higher in group of CRF[ （9. 95 ± 2.65 ） Ixg/L], PD[ （ 10. 90± 2. 55 ）μg/L] and HD [ （ 10.52 ± 4. 77 ） μg/L] than those in healthy subjects[ （4. 60 ± 1.47） μg,/L] ,NS[ （5.80 ＋2. 16） Ixg,/L] and n-NS[ （5.57 ± 1.24） μg/L] （P 〈 0. 01 ） ;（3）Serum ADPN levels in CKD patients were positively related to serum Res level（ r =0. 247 ,P 〈0. 05 ） and urinary protein excretion amount （ r = 0. 819, P 〈 0. 01 ）, and negatively related to serum albumin （ r = - 0. 686, P 〈 0. 01 ） ;（4）Serum Res levels in CKD patients were positively related to serum TNF-α （r = 0. 736） , hs- CRP（ r = 0. 619 ） and SCr（ r = 0. 641 ） （ P 〈 0. 01 ）, and negatively related to eGFR（ r = -0. 615, P 〈 0. 01 ）. Conclusion The levels of serum ADPN and Res were markedly increased in patients with CKD, and correlated with urinary protein excretion amount, s

关 键 词：脂联素 抵抗素 炎症 慢性肾脏病 

分 类 号：R692[医药卫生—泌尿科学]