高通量透析对维持性血液透析患者血浆瘦素及营养状况的影响

目的探讨高通量透析（HPD）对慢性肾衰竭（CRF）患者血浆瘦素（Leptin）及其营养状况的影响。方法将维持性透析组18例CRF患者随机分为HPD组和低通量透析（LPD）组各9例，未透析组CRF患者9例，10例健康者作为对照组，分别测定备组治疗前及透析组第24次透析后的Leptin、视黄醇结合蛋白（RBP）、前白蛋白（PA），转铁蛋白（TRF）、血白蛋白（Alb）、血红蛋白（Hb）。以及体质量指数（BMI），分析各指标相关性。结果3个月后。与LPD组比较，HPD组Leptin明显降低，营养指标明显改善（P〈0．05）；CRF患者早期TRF下降明显（P〈0．05），存在高Leptin血症，营养指标均下降（P〈0．05，〈0．01）；透析组Leptin与．BMI、RBP、Alb呈相关性（P〈0．05）。结论高Leptin血症与CRF患者营养状况有关,HPD能有效清除Leptin，改善患者的营养状况；TRF可能是反映早期CRF患者营养状况的指标之一。

Effects of high-permeable dialysis on serum leptin and nutritional status in maintenance hemodialysis patients

[Objective] To research the effects of high-permeable dialysis(HPD)on serum leptin and nutritional status in chronic respiratory failure(CRF)patients.[Methods] Eighteen dialysis CRF patients were divided randomly into two groups of 9 HPD and 9 low-permeable hemodialysis(LPD).Nine without dialysed CRF patients and 10 normal peoples were enrolled as control group.Serum leptin,retinol-binding protein(RBP),pre-albumin(PA),transferrin(TRF),albumin(ALb),haemoglobin(Hb),and body mass index(BMI)were detected before treatment in the four groups and after the 24th dialysis in dialysis groups.The correlations between the indexes were analyzed.[Results] Compared with LPD,leptin in HPD reduced remarkably and patients' nutritional indexes improved remarkably after 3 months dialysis(P<0.05);In early CRF,TRF was reduced remarkably(P<0.05),high rleptine existed(P<0.05)and all nutritional indexes were reduced remarkably(P<0.05,<0.01));Serum leptin was correlated positively with BMI,RBP and albumin in dialysed patients(P<0.05).[Conclusion] High leptin is correlated with nutritional status in CRF patients.HPD can efficiently remove serum leptin and improve patient's nutritional status;TRF may be one of the indexes which reflect nutritional status in early CRF patients.