血清YKL-40、FABP4水平与腹膜透析患者容量超负荷的关系  

Relationship between serum YKL-40 and FABP4 levels and volume overload in peritoneal dialysis patients

作　　者：罗逊[1] 刘曼婷 李世瑶 刘抗寒[1] 陈莹[1] LUO Xun;LIU Manting;LI Shiyao;LIU Kanghan;CHEN Ying(Hunan Provincial People's Hospital,Changsha 410005,China)

机构地区：[1]湖南省人民医院,长沙410005

出　　处：《山东医药》2018年第41期30-33,共4页Shandong Medical Journal

基　　金：湖南省科技厅科技计划项目(2014SK3152);湖南省人民医院仁术科研发展基金项目(2015-29)

摘　　要：目的探讨血清甲壳酶类似蛋白(YKL-40)、脂肪酸结合蛋白(FABP4)水平与腹膜透析患者容量超负荷的关系。方法选择肾内科收治的腹膜透析患者98例,并分为容量超负荷组(59例)和容量正常组(39例)。采用多频生物电阻抗(BIA)分析仪测量人体细胞外液/总液体值(ECW/TBW),采集空腹静脉血标本测定血生化指标和FABP4、YKL-40,收集患者24 h尿量检测尿素和尿肌酐,计算残余肾功能(RRF)。分析上述指标与容量超负荷的相关性。结果容量超负荷组年龄、甘油三酯(TG)、高敏C反应蛋白(hs-CRP)、FABP4、YKL-40高于容量正常组(P均<0. 05),容量超负荷组白蛋白(Alb)、RRF低于容量正常组(P均<0. 05); ECW/TBW与年龄、hs-CRP、FABP4、YKL-40呈正相关(r分别为0. 344、0. 544、0. 422、0. 395,P均<0. 05),与Alb、RRF呈负相关(r分别为-0. 424、-0. 367,P均<0. 05)。Logistic回归分析显示,hs-CRP、RRF、FABP4及YKL-40与腹膜透析患者容量负荷水平有关(P均<0. 05)。结论血清YKL-40、FABP4水平与腹膜透析患者容量负荷呈正相关,二者可能在容量超负荷进展中发挥协同作用。Objective To investigate the relationship between serum levels of chitinase-like protein(YKL-40),fatty acid binding protein(FABP4)and volume overload in the peritoneal dialysis patients.Methods Ninety-eight patients with peritoneal dialysis admitted to the department of nephrology were selected,and they were divided into the volume overload group(59 cases)and the normal volume group(39 cases).Multiple frequency bioelectrical impedance analysis(BIA)was used to measure the ratio extracellular fluid to total liquid value(ECW/TBW).Fasting venous blood sample was collected to measure the blood biochemical criterion and FABP4,YKL-40.The 24-hour urinary volume was collected,urea and urinary creatinine was measured,and residual renal function(RRF)was calculated.The correlation between the above indicators and volume overload was analyzed.Results Age,triglyceride(TG),high sensitive c-reactive protein(hs-CRP),FABP4 and YKL-40 in the volume overload group were higher than those in the normal volume group(all P<0.05),while albumin(Alb)and RRF in the volume overload group were lower than those in the normal volume group(both P<0.05).ECW/TBW was positively correlated with age,hs-CRP,FABP4 and YKL-40(r=0.344,0.544,0.422,0.395,respectively;all P<0.05),and was negatively correlated with Alb and RRF(r=-0.424 and-0.367,respectively;both P<0.05).Logistic regression analysis showed that hs-CRP,RRF,FABP4 and YKL-40 were related to the volume load level of peritoneal dialysis patients(all P<0.05).Conclusion The levels of serum YKL-40 and FABP4 are positively correlated with the volume load of peritoneal dialysis patients,both of which may play a synergistic role in the progression of volume overload.

关 键 词：腹膜透析 容量负荷 甲壳酶类似蛋白 脂肪酸结合蛋白 

分 类 号：R692[医药卫生—泌尿科学]