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目的检测终末期肾脏病(ESRD)透析和非透析患者血清抵抗素、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)及血清白蛋白、血脂、肾功能水平,探讨ESRD患者血清抵抗素水平的变化及与各影响因素的关系。方法选择ESRD患者60例,分为3组:肾衰非透析组(18例)、血液透析组(22例)和腹膜透析组(20例),另设正常对照组(20例)。用ELISA方法检测血清抵抗素、TNF-α和hs-CRP,同时常规测定血肌酐(SCr)、血清白蛋白、血总胆固醇和甘油三酯。比较各组间的差别。结果(1)患者血清抵抗素水平在肾衰非透析组[(9.95±2.65)mg/L]、血液透析组[(10.52±4.77)mg/L]和腹膜透析组[(10.90±2.55)mg/L]均显著升高,与对照组[(4.60±1.47)mg/L]相比,差异有统计学意义(P<0.01),但三组之间比较差异无统计学意义(P>0.05)。(2)ESRD患者血清抵抗素水平与TNF-α(r=0.539)、hs-CRP(r=0.406)、SCr(r=0.340)呈正相关(P<0.01),与肾小球滤过率(GFR)呈负相关(r=-0.807,P<0.01)。结论在终末期肾脏病,无论血液透析、腹膜透析还是非透析患者,其血清抵抗素水平均明显升高,并与TNF-α、CRP、GFR等因素有关。抵抗素可能对ESRD患者的亚临床炎症起一定作用。
Objective To detect serum resistin, tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and serum albumin, serum lipids and renal function in patients with end-stage renal disease (ESRD) To investigate the changes of serum resistin levels in ESRD patients and its relationship with various influencing factors. Methods Sixty ESRD patients were divided into three groups: control group (n = 18), hemodialysis group (n = 22) and peritoneal dialysis group (n = 20). Serum resistin, TNF-α and hs-CRP were detected by ELISA, and serum creatinine (SCr), serum albumin, total cholesterol and triglyceride were measured routinely. Compare the differences between the groups. Results Serum resistin level was significantly higher in patients with renal failure than dialysis group [(9.95 ± 2.65) mg / L], hemodialysis group (10.52 ± 4.77 mg / L) and peritoneal dialysis group [(10.90 ± 2.55) mg / L] were significantly higher than those in the control group [(4.60 ± 1.47) mg / L] (P <0.01), but there was no significant difference between the three groups (P> 0.05 ). (2) Serum resistin levels in ESRD patients were positively correlated with TNF-α (r = 0.539), hs-CRP (r = 0.406) and SCr (r = 0.340) GFR) (r = -0.807, P <0.01). Conclusions In patients with end-stage renal disease, serum resistin levels are significantly elevated in patients with hemodialysis, peritoneal dialysis or non-dialysis, and are associated with TNF-α, CRP, GFR and other factors. Resistin may play a role in subclinical inflammation in ESRD patients.