不同肾脏疾病时leptin与NPY的水平变化

目的：探讨不同肾脏疾病时血浆瘦素（leptin）和神经肽Y（NPY）的水平变化及意义。方法：应用放射免疫分析对176例不同肾脏疾病患者血清leptin及血浆NPY水平进行检测，并与35例正常人进行对比。结果：与对照组比较，糖尿病肾病、慢性肾功能不全及血液透析前后血清leptin水平均增高显著（P〈0．05；P〈0．01；P〈0．01）。血浆NPY水平在慢性肾功能衰竭和血液透析前后显著增高（P〈0．01；P〈0．01）。其他各组与对照组比较均无显著性差异（P〉0．05）。与血透前比较，血透后leptin和NPY水平明显降低有显著性差异（P〈0．05；P〈0．05）。相关性分析显示，慢性肾功能衰竭组和血液透析组leptin与NPY之间均呈正相关（r=0．68。t=3．62，P〈0．01；r=0．58，t=4．02，P〈0．01），其他各组间无相关性。结论：慢性肾脏疾病和慢性肾功能衰竭患者存在高leptin、NPY血症；血液透析过程能增加leptin和NPY的清除率，改善患者的营养状态。

The Levels of Serum Leptin and Plasma Neuropeptide Y in Patients with Various Kinds of Kidney Diseases

Objective To investigate the clinical significance of changes of serum levels of leptin(LEP) and plasma levels of neuropeptide Y(NPY) in patients with various kinds of kidney disease.Methods The serum concentrations of LEP and plasma concentrations of NPY were measured with radioimmunoassay in 176 patients with different kinds of kidney disease and 35 controls.Results The serum level of LEP were significantly higher in patients with diabetic nephropathy,chronic renal insufficiency,patients on dialysis both before and after the procedure than those in controls(P<0.05,P<0.01,P<0.01 vs control).The level of plasma NPY were significantly higher in patients with chronic renal insufficiency,and patients on dralysis before and after the procedure than those in controls(P<0.01,P<0.01 vs control).The concentration of LEP and NPY dropped significantly after the procedure in patients on hemodialysis(P<0.05,P<0.05).The serum level of LEP were positively correlated with the level of plasma NPY in patients with chronic renal insufficiency and patients on hemodialysis(r=0.68,t=3.62,P<0.01,r=0.58,t=4.02,P<0.01).Conclusion The level of LEP and NPY were significantly increased in patients with chronic renal disease and chronic renal failure.Hemodialysis could increase the clearance rate of LEP and NPY and improve the clinical nutritional status of the patients.