慢性肾功能衰竭患者血清瘦素水平的变化及其意义

目的探讨慢性肾功能衰竭(chronicrenalfailure,CRF)患者血清瘦素(Leptin)水平,并观察瘦素与肾功能(BUN、SCr、UA、CCr)、人体营养指标(TP、ALB、Chol、HCT、RBC、Hb、PCR、BMI)之间的关系。方法以放射免疫分析法测定68例CRF患者血清瘦素的浓度,并与健康组进行比较,分析瘦素与肾功能之间的关系。同时测定患者的血浆蛋白、血常规及身高与体重,计算CCr、PCR。结果健康组血清瘦素浓度为(1.9543±0.4721)μg/L,CRF患者血清瘦素浓度为(2.8668±0.9026)μg/L,与健康组比较具有极显著差异(P<0.01);在CRF患者不同分期中,血清瘦素浓度随CCr的下降而升高,Leptin与SCr、UA水平呈正相关(P<0.05或P<0.01),与CCr、TP、RBC、Hb、PCR水平呈负相关(P<0.05或P<0.01),与年龄、BUN、ALB、Chol、HCT、BMI之间未发现有显著性差异。结论慢性肾功能衰竭时血清瘦素水平明显升高,其升高程度与肾功能的恶化具显著相关性。高瘦素血症可导致患者营养不良,血清瘦素可作为评价人体营养状况的一个重要指标。

The change and significance in serum leptin levels of chronic renal failure (CRF) patients

Objective To explore the serum levels of leptin in CRF patients, and to observe the relationship between the leptin and CRF, human nutrition. Methods Sixty-eight CRF patients and thirty healthy control subject were recruited for the study. Serum leptin was measured by using a human leptin radio-immunoassay (RIA) kit. There were also test to measure creatinine clearance (CCr), plasma protein, blood routine,body height and body weight being used to caculate CCr,PCR, was measured at the same time. Results Mean serum level of leptin was significantly higher in CRF group than that in the healthy group (P<0.01). With the decreasing of CCr, the serum levels of leptin in CRF patients increased with it in different period of CRF. There have significant positive correlations in CRF patients among leptin levels and serum creatinine (SCr), uric acid (UA) (P<0.05 or P<0.01),and negative correlation in CRF patients between leptin levels and CCr, TP, RBC, Hb, PCR(P<0.05 or P<0.01). There have significant correlations between of levels leptin and age, BUN, ALB, Chol, HCT, BMI. Conclusion It suggests that serum leptin levels increased markedly in CRF patients, and there are significant correlations between the serum levels of leptin and the renal function worsen. Dystrophia can be resulted from hypsi-leptin-emia, and serum leptin can be used as an important index to evaluate body nutritional state.