透析患者血浆Ghrelin水平与心血管功能及预后的关系

目的检测腹膜透析和血液透析患者空腹血浆胃饥饿素（ghrelin）水平，探讨它与患者心血管功能及预后的关系。方法用酶联免疫吸附法（ELISA）测定北京大学第三医院肾内科30例腹膜透析患者、30例血液透析患者和20例健康对照者的空腹血浆ghrelin水平并进行比较，同时对透析患者的血浆ghrelin水平与心脏超声指标、脉搏波速度（Pwv）进行相关分析，对有心脑血管疾病组和无心脑血管疾病组及生存组和死亡组的血浆ghrelin水平进行比较。结果透析患者的空腹血浆ghrelin水平明显高于健康人群（P〈0．0001）。透析患者血浆ghrelin水平与左心室射血分数正相关（r=0．641，P〈0．01），与PWV无相关性（r=0．341，P=0．12）。有心脑血管疾病组和无心脑血管疾病组的血浆ghrelin水平差异无显著性（P=0．516）。生存组和死亡组的血浆ghrelin水平差异无显著性（P=0．43）。结论透析患者血浆ghrelin水平明显高于正常人。透析患者的血浆ghrelin水平与心脏收缩功能呈正相关，而与大动脉僵硬度无明显关系，也与心脑血管疾病的发生及患者的预后无关。

Plasma ghrelin level and its relationship with cardiovascular function and prognosis in maintenance dialysis patients

Objective To study the correlations between the plasma ghrelin level and cardiovascular function,prognosis in maintenance dialysis patients.Methods Measuring and comparing the level of fasting plasma ghrelin by ELISA in 30 peritoneal dialysis,30 hemodi-alysis patients and 20 normal controls.Also exploring the correlations between the plasma ghrelin levels and the parameters from ultrasound cardiogram,pulse wave velocity.Comparing the level of plasma ghrelin between the group with and without cardiovascular disease,also between the survivors and the dead.Results The fasting plasma ghrelin levels in dialysis groups were much higher than that in controls(P<0.0001).In dialysis groups the plasma ghrelin levels were positively correlated with left ventricular ejection fraction(r=0.641,P<0.01),and were not correlated with pulse wave velocity(PWV)(r=0.341,P=0.12).There was no differ-ence in the levels of plasma ghrelin between subgroups with and without cardiovascular disease(P=0.516).So was between the survivors and the dead(P=0.43).Conclusions The fasting plasma ghrelin levels in dialysis groups were much higher than that in controls.The plasma ghrelin levels in dialysis patients were positively correlated with their cardiac systolic function whereas there were no significant relations between the plasma ghrelin levels and arterial stiffness,cardiovascular disease morbidity and prognosis.