慢性肾功能衰竭代谢性酸中毒患者血清瘦素水平变化及其意义  

The relationship between serum leptin level and metabolic acidosis in patients with chronic renal failure

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6期485-487,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的　观察慢性肾功能衰竭 (CRF)代谢性酸中毒 (代酸 )患者酸中毒纠正前后血清瘦素浓度的变化 ,确定这种变化与代谢性酸中毒间的关系及其对蛋白营养不良的影响。方法　采用放射免疫分析法测定CRF代酸患者血清瘦素水平 ,并与正常对照组进行比较 ,分析其与血生化、血气分析、体重指数 (BMI)等指标之间的关系。结果　CRF代酸患者血清瘦素浓度于纠酸前、纠酸后即刻和纠酸后 3d分别为 (14.2 3± 12 .0 6 )、(14.18± 12 .5 8)及(18.73± 15 .98) μg/L ,纠酸后 3d较前明显升高 (P <0 .0 5 ) ;且受BMI和血清白蛋白 (Alb)的影响 ,血清瘦素浓度与BMI和Abl间的线性回归方程为 :血清瘦素 (μg/L) =- 5 6 .132 0 +1.6 2 13BMI(kg/m2 ) +0 .96 2 5Alb (g/L) (P <0 .0 1)。结论　CRF代谢性酸中毒抑制血清瘦素的分泌 ,血清瘦素浓度的高低与营养不良无关。Objective To study the relationship between the level of serum leptin and metabolic acidosis and their significance to the protein-malnutrition in patients with chronic renal failure (CRF).?Methods The concentrations of serum leptin determined by radioimmunoassay in CRF patients with metabolic acidosis were studied to reveal their relationship to certain biological indexes.?Results The normal serum leptin was 10.04±7.0 (μg/L), related to body mass index (BMI) ( t =2.197, P =0.0331), and was higher in males than in females ( t =3.1946, P <0.01). The level of leptin in patients with CRF was (14.23±12.06), (14.18±12.58) and (18.73±15.98)μg/L respectively before and immediately and 3 days after correction of metabolic acidosis, showing that the concentration of leptin was significantly increased in 3 days after correction of metabolic acidosis. Multivariate regression analysis showed that the level of leptin in patients was influenced by BMI and concentration of serum albumin, the regression equation was as follows: leptin(μg/L)=-56.1320+1.6213 BMI(kg/m 2)+0.9625 Alb(g/L) ( P <0.01).?Conclusion The metabolic acidosis inhibits the secretion of leptin in CRF patients, and the leptin seems to have no important effects on protein-malnutrition here.

关 键 词：慢性肾功能衰竭 蛋白营养不良 瘦素 体重指数 代谢性酸中毒 

分 类 号：R692.5[医药卫生—泌尿科学] R589.6[医药卫生—外科学]