腹膜透析患者血清瘦素清除情况分析  

Clearance effect of peritoneal dialysis on leptin

作　　者：张莉[1] 刘佳[1] 徐冬梅[1] 邢昌赢[1] 

机构地区：[1]南京医科大学第一附属医院肾内科,江苏南京210029

出　　处：《东南大学学报（医学版）》2010年第5期539-542,共4页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨腹膜透析对血清瘦素的清除作用。方法:采用放免法测定20例腹膜透析患者血清、24 h尿、24 h腹透液标本中的瘦素浓度。同时测定腹膜透析充分性指标和其它生化指标。结果:患者组血清瘦素浓度为(20.03±10.12)μg.L-1,明显高于正常对照组(P<0.01)。腹膜透析液的瘦素浓度为(5.68±4.72)μg.L-1,与血清瘦素浓度呈正相关(r=0.821,P<0.001)。24 h腹膜透析对瘦素的清除量为(41.95±32.89)μg,亦与血清瘦素浓度呈正相关(r=0.795,P<0.001)。而腹膜透析的每周瘦素清除率与血瘦素水平无明显相关性(r=0.122,P>0.05)。患者有低白蛋白血症[(33.03±5.28)g.L-1],但无明显血脂异常。结论:腹膜透析患者中存在低白蛋白血症和高瘦素血症;腹膜透析可以清除瘦素,其清除量与血瘦素浓度呈正相关。Objective： To determine the clearance of serum leptin by peritoneal dialysis and factors related to tins process. Methods： 20 CAPD patients and 13 healthy subjects were enrolled in this study. Leptin was detected by radioimmunoassay method in serum, 24 h urine collection and 24 h peritoneal dialysate collection. Other biochemi- cal indexes in serum were also measured. Results： Serum leptin of CAPD group was （20.03 ± 10.12） μg·L^-1 , which was significantly higher than that of healthy control（P 〈0.01 ）. Peritoneal dialysate leptin concentration was （5.68 ± 4.72 ） μg·L^-1, which was positively correlated with the serum leptin concentration （ r = 0. 821, P 〈 0. 001 ）. Total leptin cleared by 24 h peritoneal dialysis was （41.95± 32.89 ） μg, which was also positively correlated with the serum leptin concentration. The clearance rate of leptin by peritoneal dialysis was（ 14.19 ± 8.13 ） L·w^-1. （1.73 m^2）^-1, which has no correlation with serum leptin concentration（ r = 0. 122, P 〉 0.05 ）. CAPD group had hypoalbuminemia（33.03± 5.28） g·L^-1 without significant dyslipidemia. Conclusion ： CAPD patients have hypoalbuminemia and hyperleptinemia. Leptin can be partly cleared by peritoneal dialysis. The amount of clearance is positively correlated with the serum leptin concentration.

关 键 词：腹膜透析 瘦素 清除 

分 类 号：R459.5[医药卫生—治疗学]