肺感染致多器官功能障碍综合征血清瘦素浓度的变化

目的检测肺部严重感染所致多器官功能障碍综合征(MODS)、急性心肌梗死(AMI)和心律失常(AR)等危重症患者血清中瘦素(Leptin)及相关因子水平的变化,探讨Leptin在MODS发病及诊断中的可能意义。方法采用放射免疫分析法测定Leptin、脂肪酸结合蛋白(FABP)、转铁蛋白(Ferr)以及白细胞介素1β(IL1β)水平,采用酶联免疫吸附法(ELISA)测定C反应蛋白(CRP)水平。结果与正常对照组相比,Leptin水平在MODS、AMI和AR组均明显增高(P均<0.01);CRP和IL1β水平在MODS、AMI和AR组均显著增高(P<0.05或P<0.01),以MODS组患者增高更明显(P均<0.05);FABP和Ferr在3组患者中也均有明显上升趋势,特别是在MODS组中上升更多,但统计学上差异无显著性。结论肺感染所致MODS患者血清中Leptin水平明显上升,伴有CRP和IL1β同时升高,Leptin可能在MODS的发生和转归中发挥一定作用。

Changes of serum leptin level in pulmonary infection-induced multiple organ dysfunction syndrome

OBJECTIVE: To determine serum levels of leptin and some related cytokines in severely ill patients, including severe pulmonary infection-induced multiple organ dysfunction syndrome (MODS), acute myocardial infarction (AMI) and arrhythmia (AR), and to explore the possible role of leptin in the pathogenesis and diagnosis of MODS. METHODS: Radioimmunoassay was used to determine leptin, fatty acid binding protein (FABP), transferrin (Ferr) and interleukin-1beta (IL-1beta), and enzyme-linked immuno adsorbant assay (ELISA) was used to assess C reactive protein (CRP). RESULTS: Compared with normal individuals, leptin levels in MODS, AMI and AR patients increased significantly (all P<0.01). CRP and IL-1beta levels also increased significantly in MODS, AMI and AR patients, but the changes were more marked (all P<0.05) in MODS patients than in the patients of other two diseases (both P<0.05). Though FABP and Ferr levels of patients in all the three groups of patients showed a trend toward increase, especially in MODS patients, there was no significant difference between them and normal individuals. CONCLUSION: Serum leptin level increases significantly in pulmonary infection-induced MODS patients with a simultaneous increase of CRP and IL-1beta levels, and the result suggests that leptin plays a possible role in the pathogenesis and prognosis of MODS.