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目的 :初步探讨正常人与慢性肾功能衰竭 (CRF)伴代谢性酸中毒 (代酸 )患者血浆食欲素A浓度的测定方法、浓度变化及其意义。 方法 :正常健康对照组 39例 ,CRF患者 2 6例。采用层析方法将血浆去蛋白化处理及放射免疫分析法测定两组血浆食欲素A水平 ,并比较CRF组代酸纠正前、后血浆食欲素A及血清瘦素浓度的变化。 结果 :健康组血浆食欲素A浓度为 (6 17± 3 4 8)ng/L ,血清瘦素浓度为 (6 17± 6 13) μg/L。CRF代酸患者血浆食欲素A浓度于纠酸前、后分别为 (10 6± 5 33)ng/L及 (8 17± 4 6 5 )ng/L。纠酸前血浆食欲素A水平较正常对照组显著增高 (P <0 0 0 5 ) ;纠酸后其水平比纠酸前明显下降 (P <0 0 5 ) ,但与正常对照组相比仍明显升高 (P <0 0 5 )。CRF代酸患者 (纠酸前 )血清瘦素浓度为 (18 6± 18 1) μg/L ,明显高于对照组 (P <0 0 1) ;纠酸后其浓度为(32 0± 2 8 2 ) μg/L ,较纠酸前进一步升高 (P <0 0 5 )。 结论 :CRF患者血浆食欲素A及血清瘦素水平较正常人明显升高且与酸中毒程度呈正相关 ;碱性药物治疗可使CRF患者血浆食欲素A水平明显下降 ,而血清瘦素水平进一步升高。代酸很可能是抑制瘦素合成或分泌 ,促进血浆食欲素A水平升高的重要因素。
Objective: To investigate the method and concentration of plasma orexin A concentration in normal subjects and patients with chronic renal failure (CRF) and metabolic acidosis (acidosis). Methods: 39 healthy controls and 26 CRF patients. Plasma chromatin deproteinization and radioimmunoassay were used to determine the levels of plasma orexin-A in the two groups. The levels of plasma orexin-A and serum leptin in the CRF group before and after the acid replacement were compared. Results: The concentration of plasma orexin A in healthy group was (6 17 ± 34 48) ng / L and the serum leptin concentration was (6 17 ± 6 13) μg / L. The levels of plasma orexin A in patients with CRF were (10 6 ± 5 33) ng / L and (8 17 ± 45 65) ng / L before and after the correction of acidosis respectively. The level of plasma orexin A before correction was significantly higher than that of the normal control group (P <0.05). After correction, the level of plasma orexin-A was significantly lower than that before the correction (P <0.05) Was significantly higher (P <0 05). The concentration of serum leptin in patients with CRF (pretreatment acid) was (18 6 ± 18 1) μg / L, which was significantly higher than that in the control group (P 0 01) 2) μg / L, which was higher than that before correction (P <0 05). CONCLUSIONS: Plasma orexin-A and serum leptin levels in patients with CRF were significantly higher than those in normal subjects and positively correlated with the degree of acidosis. Alzheimer’s drug treatment significantly decreased plasma orexin-A level in CRF patients and serum leptin levels were further increased high. Substitution of acid is likely to be an important factor that inhibits leptin synthesis or secretion and promotes the elevation of plasma orexin-A levels.