尿毒症患者血清脂联素与慢性炎症状态的临床意义研究

目的：通过检测尿毒症患者血清脂联素与体内炎症指标的水平,分析血清脂联素与体内炎症反应的关系,探讨血清脂联素对心血管疾病影响的机制。方法：在本实验中,采用ELISA方法测定60例尿毒症患者的血清脂联素（adiponectin,ADPN）水平,炎症指标血C-反应蛋白（C-reactive protein,CRP）,肿瘤坏死因子（tumor necrosis factor,TNF-α）,纤维蛋白原（fibrinogen,Fbg）,并分析血清脂联素与炎症指标、颈动脉斑块的关系。结果：在所有研究对象中有46.7%的患者CRP水平超过正常参考值5 mg/L。在实验组中血ADPN、TNF-α、Fbg均高于健康对照组（P值均〈0.05）并且单因素相关分析结果表明血ADPN与CRP、TNF-α、Fbg均呈明显负相关,相关系数分别为-0.49、-0.51、-0.43（P值均〈0.01）。有颈动脉粥样斑块患者血清显著降低（11.23±4.92）μg/ml与无颈动脉粥样斑块患者血清ADPN（15.71±4.68）μg/ml相比差异有统计学意义（P〈0.01）。结论：在尿毒症患者中,血清脂联素水平与体内炎症反应密切相关,脂联素可能是一种负性炎症因子并具有心血管系统的保护作用。

The Clinical Significance of Serum Adiponectin and Chronic Inflammation in Uremia Patients

Objective：By detecting the level of adiponectin and inflammation index in vivo in uremia patients and analyzing the relationship of adiponectin and Inflammatory reaction as well as the mechanism of influence of adiponectin with cardiovascular disease.Methods：The level of adiponectin and chronic inflammatory respones induce including C-reactive protein（CRP） tumor necroses factor-a（TNF-α） and fibrinogen（Fbg） were detected in 60 patients with uremia by ELISA and adiponectin inflammation index and carotid artery plaque were analyzed.Results：In all objects CRP level that surpasses normal reference value that is 5 mg/L in 46.7% patients.In the experimental group the level of adiponectin,tumor necrose factor-a and fibrinogen is higher than those of healthy control（P〈0.05）and ADPN negatively correlated with CRP,TNF-a,Fbg and Coefficient of correlation is-0.49,-0.51,-0.43（P〈0.01）.the statistical significance between the level of adiponectin in carotid artery plaque patients significantly degraded（11.23±4.92）μg/ml and the level of adiponectin in none carotid artery plaque patients（15.71±4.68）μg/ml is masccline P0.01.Conclusion：The level of serum adiponectin closely correlates with internal Inflammatory reaction in uremia patients.adiponectin may be a protectional factor.and have protection to cardiovascular system.