维持性血液透析患者血清脂联素与左心室肥厚的相关性分析

目的探讨维持性血液透析（MHD）患者血清脂联素（ADPN）水平与左心室肥厚（LVH）的相关性。方法选择我院MHD患者79例，行心脏超声心动图测定左心室舒张末期内径（LVDd）、左心室收缩末期内径（LVDs）、室间隔厚度（IVST）、左心室后壁厚度（LVPwT）、左心室射血分数（EF），计算左心室质量指数（LVMI）。按照LVMI值将79例MHD患者分成LVH组和非LVH组，选择同期健康者16名为对照组。测定3组血清ADPN、血糖、胰岛素、血脂、C反应蛋白（CRP），计算体重指数（BMI）、稳态模型胰岛素抵抗指数，分析血液透析患者血清ADPN水平与上述参数及LVH之间的相关性。结果LVH组和非LVH组的血清ADPN均高于对照组，LVH组血清ADPN低于非LVH组，而胰岛素、胰岛素抵抗指数、CRP高于对照组和非LVH组；MHD患者血清ADPN与胰岛素、胰岛素抵抗指数、CRP、LVMI呈明显负相关，胰岛素抵抗指数、CRP与LVMI呈明显正相关。结论MHD患者血清ADPN水平与慢性炎症及胰岛素抵抗关系密切，可能共同参与了LVH的发生和发展。

Correlation between serum adiponectin and left ventricular hypertrophy in patients undergoing maintenance hemodialysis

Objective To explore the correlation of serum level of adiponectin （ADPN） with left ventricular hypertrophy （LVH） in patients undergoing maintenance hemodialysis （MHD）. Methods Seventy-nine MHD patents and 16 healthy individuals （control group） were selected. The left ventric- ular end-diastolic diameter （LVI）d）, left ventricular end-systolic diameter （LVDs）, interventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT） and ejection fraction （EF） were measured by ultrasonic cardiography, and left ventricular mass index （LVMI） was calcu- lated. Seventy-nine MHD patents were divided into two groups： LVH group and non-LVH group. Serum ADPN, fasting glucose, fasting insulin, lipoprotein, and C-reactive protein （CRP）were deter- mined, and BMI, homeostasis model assessment-insulin resistance index were calculated by established formulas. The correlation of ADPN with above parameters and LVH was analyzed. Results The aver- age serum ADPN levels in the LVH group and non-LVH group were significantly higher than in the control group, and serum ADPN in the LVH group was significantly lower than in the non-LVH group. Insulin resistance index and CRP in the LVH group were significantly higher than in the control group and non-LVH group. ADPN was negatively correlated with insulin, insulin resistance index,CRP and LVMI. Insulin resistance index and CRP were positively correlated with LVMI. Conclusion The level of ADPN in MHD patients is closely correlated with inflammation and insulin resistance, and they are probably involved in the pathogenesis and progression of LVH.