慢性肾功能衰竭血液透析患者血清瘦素的变化及其意义  

Changes of serum leptin and its significance in patients with chronic renal failure on hemodialysis

作　　者：仇新霞[1] 郑法雷[2] 李艳[2] 

机构地区：[1]徐州医学院保健科,江苏徐州221002 [2]中国医学科学院中国协和医科大学北京协和医院肾内科,北京100730

出　　处：《徐州医学院学报》2001年第2期96-99,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的　明确慢性肾功能衰竭 (CRF)患者血液透析 (简称“血透”)前后血清瘦素水平的变化 ,并探讨其与蛋白营养不良的关系。方法　以放射免疫分析法测定CRF患者血透前后血清瘦素的浓度 ,并与正常对照组进行比较 ,分析其与肾功能及血气分析等指标之间的关系。结果　正常对照组血清瘦素浓度为 (10 .0 4± 7.0 0 ) μg/L ,血清瘦素浓度与体重指数 (BMI)呈明显相关 (r =0 .41,P <0 .0 1) ,且女性血清瘦素浓度较男性高 (P <0 .0 1)。血透患者透析前血清瘦素浓度 (11.76± 12 .19) μg/L ,与对照组比较无显著差异 ;透析后血清瘦素浓度为 (12 .2 3± 14.5 0 ) μg/L ,与透析前比较亦无显著差异。血透患者血清瘦素浓度仍然与BMI有关 ,其相关系数为 0 .39(P <0 .0 1) ,这些患者透析前血清瘦素浓度受到年龄、血清白蛋白、甘油三酯、尿素氮的影响 ,其回归系数分别为0 .2 2 80、0 .90 2 5、3.0 85 3和 - 0 .0 949,P均 <0 .0 5。结论　本组CRF患者血清瘦素水平并不升高 ,血透前后血清瘦素水平亦无明显变化 。Objective To examine the changes of serum leptin level in patients with chronic renal failure (CRF) on hemodialysis and the relationship between leptin levels and protein-malnutrition. Methods The body mass index (BMI) was measured and the concentrations of serum leptin albumin, BUN, Cr and other biochemical parameters were determined using radioimmunoassay before and after hemodialysis in CRF patients. Results The serum leptin level was (10.04±7.00) μg/L in normal control group and related to BMI (r=0.41,P<0.01). It was higher in males than in females (P< 0.01). The leptin level in CRF patients was (11.76±12.19) μg/L and (12.23±14.50) μg/L before and after hemodialysis respectively (P>0.05 vs controls). Multivariate regression analysis showed that the leptin level in patients on dialysis was influenced by age and concentrations of serum albumin, triglyceride and BUN, and the regression coefficients were 0.228?0, 0.902?5, 3.085?3 and -0.094?9 respectively (all P<0.05). Conclusion No increase in serum leptin level was found in CRF patients and this level was not influenced by hemodialysis. Further study to define the exact role of leptin in CRF patients' protein-malnutrition is needed.

关 键 词：慢性肾功能衰竭 瘦素 血液透析 蛋白营养不良 

分 类 号：R692.5[医药卫生—泌尿科学] R459.5[医药卫生—外科学]