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

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摘要目的：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112例，分为CKD 1期组、CKD 2期组、CKD 3期组、CKD 4期组、CKD 5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：CKD 1～CKD 5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=0.506，r=0.522，r=0.384，r=0.437，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。

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	陈辉乐1
	徐昌隆2
	徐晓杰3
	周志宏1

Abstract：Objective: To explore the changes of the level of serum adiponectin (ADPN) in chronic kidney disease (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 CKD1 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.

收稿日期: 2013-09-11

基金资助:温州市科技计划资助项目（Y20110115）

通讯作者: 周志宏，主任医师，Email：markzhou@wzhealth.com

作者简介: 陈辉乐（1977-），女，浙江温州人，主治医师，医学硕士

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2014/V44/I1/35

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