慢性肾脏病患者血清脂联素水平的变化、影响因素及其意义

目的：探讨慢性肾脏病（CKD）患者血清脂联素（ADPN）水平的变化、影响因素及其意义。方法：选择CKD患者u2例，分为CKD1期组、CKD2期组、CKD3期组、CKD4期组、CKD5期组；以健康体检者30名为对照组。检测肾功能指标Scr和eGFR，采用酶联免疫吸附法（ELISA法）测定血清高敏C反应蛋白（hs—CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6），硫代巴比妥酸法检测血清丙二醛（MDA）含量。结果：CKD1～CKD5期患者的ADPN、hs—CRP、TNF-α、IL-6和MDA均明显高于对照组，差异有统计学意义（P〈0．05或P〈0．01），且上述指标都呈阶梯式升高变化，相邻组间比较差异均有统计学意义（P〈0．05或P〈0．01）。相关分析显示，ADPN与hs—CRP、TNF-α、IL-6以及MDA皆呈显著正相关关系（分别为r=-O．506，r=O．522，r=O．384，r=O．437，均P〈0．01）。结论：CKD患者血清ADPN水平随着病情的演进而显著逐步升高，微炎症状态、氧化应激和肾功能下降之间相互诱导，协同作用可能是其主要原因。

Change of serum adiponectin,its influence factors and significance in chronic kidney disease patients

Objective： To explore the changes of the level of serum adiponectin （ADPN） in chronic kidneydisease （CKD） patients in different periods, its influence factors and significance. Methods： One hundred and twelve patients with CKD were divided into five groups： 1, 2, 3, 4, 5 stages of CKD groups and 30 normal healthy persons as control group. To investigate serum creatinine （Scr）, glomerular filtration rate （GFR）. Serum ADPN, high-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） were measured by Enzyme-linked immunoabsorbent assay （ELISA） and methyl dialdehyde （MDA） was examined with sulfo-barbituric acid. Results： Serum ADPN, hs-CRP, TNF-α, IL-6 and MDA in patients from CKD 1 stage to CKD5 stage were significant higher than that in control group （P〈0.05 or P〈0.01）, moreover, all index were increased step by step, existed significant difference between border upon groups （P〈0.05 or P〈0.01）. There were significant positively correlations between the ADPN and hs-CRP （r=0.506）, TNF-α（r=-0.522）, IL-6 （r=0.384）, and MDA （r=-0.437） （all P〈0.01）. Conclusion： With the progress of state of an illness of CKD patients, serum ADPN level remarkably gradually elevates. Among micro-inflammation, oxidative stress and decline of renal function induce each other, cooperation may be main causes of change of serum adiponectin.