尿毒症患者血清瘦素水平的临床研究

目的研究慢性肾功能不全患者血液透析前、后的血清瘦素水平与健康人群血清瘦素的关系,并初步探讨血清瘦素水平与营养不良的关系.方法选择尿毒症患者(血液透析前、连续血液透析三次后)及正常对照组各30例,于空腹取血,应用放射免疫分析法测定血清中瘦素水平,同时检测肾功能、血浆白蛋白水平等.结果正常人的血清瘦素水平与尿毒症患者血液透析前的血清瘦素水平无显著性差异(P>0.05),两组血清瘦素水平与体重指数(BMI)呈明显正相关(P<0.05),且女性血清瘦素水平均分别高于男性(P<0.05);尿毒症患者血液透析后的血清瘦素水平与正常对照组差异有显著性(P<0.05),血液透析组的血清瘦素水平与血尿素氮、肌酐、白蛋白等无相关性,血液透析组的肌酐、尿素氮高于对照组(P<0.01);血液透析前与血液透析后的血清瘦素水平无显著性差异(P>0.05).结论尿毒症患者血液透析前的血清瘦素水平与对照组差异无显著性,而血液透析后的血清瘦素与对照组差异有显著性;尿毒症患者和正常对照组女性血清瘦素水平均明显高于男性;尿毒症患者血液透析后血清瘦素水平与患者营养不良无明显相关关系;血液透析无法对瘦素起到清除作用.

Clinical investigation of serum leptin level in uremia patients

Objective To investigate the relationship between the leptin levels of chronic renal failure patients(before and after hemodialysis) and those of normal controls. Methods Thirty CRF patients(before and after hemodialysis) and thirty healthy control subjects were selected for the study, blood was drawn after an overnight fast.Leptin levels were determined by radioimmunoassay.There were also blood tests to measure BUN, creatinine, serum albumin etc. Results There were no significant differences between the leptin levels of CRF patients before hemodialysis and those of the controls, and the leptin levels in both groups correlated positively with body mass index(BMI), the leptin levels in females were significantly higher than in males; There were significant differences between the leptin levels of CRF patients after hemodialysis and those of the controls, hemodialysis group had significantly higher concentration of BUN, creatinine. No significant correlations were observed in hemodialysis group between the leptin levels and BUN, creatinine or serum albumin. There were no significant differences of leptin levels in those patients (before and after hemodialysis).Conclusion There were no significant differences between the leptin levels of CRF patients before hemodialysis and those of the controls, but CRF patients (after hemodialysis) are contrary. The leptin levels in females were significantly higher than in males. No significant correlations were observed in hemodialysis patients between leptin and malnutrition. Hemodialysis couldn't reduce the leptin concentrations.