论文部分内容阅读
目的:探讨慢性肾脏病(chronic kidney disease,CKD)5期患者血清瘦素变化以及与临床和血生化指标的关系,评估严重继发性甲状旁腺功能亢进患者行甲状旁腺切除术(parathyroidectomy,PTX)对上述指标的影响。方法:对113例CKD 5期患者和76例健康人进行横断面研究,并对PTX成功组(n=23)和PTX失败组(n=4)进行随访,记录其临床特征、血生化及血清瘦素水平。结果:在健康男性人群,血清瘦素水平与年龄和体质指数(body mass index,BMI)呈正相关,与血白蛋白(albumin,Alb)水平呈负相关;健康女性中,血清瘦素水平与BMI呈正相关。与健康人相比,CKD患者血清瘦素水平无明显差异。男性患者血清瘦素与BMI、血糖、甘油三酯(triglyceride,TG)和Alb呈正相关,与高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDLC)和甲状旁腺激素(intact parathyroid hormone,iPTH)负相关;女性患者血清瘦素与BMI、血红蛋白(hemoglobin,Hb)、红细胞压积(hematocrit,Hct)和TG正相关,与HDL-C负相关。PTX成功组术后血瘦素升高值与增高的体重、Hb、Hct以及下降的血iPTH值呈正相关,手术未成功组无上述变化。结论:CKD 5期患者血清瘦素水平与健康人无差异,但与患者异常的骨矿物质代谢、造血和营养有关,成功的PTX使血清瘦素升高并与上述指标改善相关。
Objective: To investigate the changes of serum leptin level in patients with chronic kidney disease (CKD) stage 5 and their relationship with clinical and biochemical markers, and to evaluate the efficacy of parathyroidectomy in patients with severe secondary hyperparathyroidism PTX) on the above indicators. Methods: A total of 113 patients with CKD stage 5 and 76 healthy subjects were studied in a cross-sectional study. The PTX success group (n = 23) and PTX failure group (n = 4) were followed up and their clinical characteristics, blood biochemistry and serum Leptin level. Results: Serum leptin level was positively correlated with age and body mass index (BMI) and negatively correlated with albumin (ALB) levels in healthy males. In healthy women, serum leptin level was positively correlated with BMI Was positively correlated. There was no significant difference in serum leptin levels between CKD patients and healthy people. Serum leptin was positively correlated with BMI, triglyceride (TG) and Alb in male patients, negatively correlated with high density lipoprotein cholesterol (HDLC) and intact parathyroid hormone (iPTH) negative . Serum leptin levels in female patients were positively correlated with BMI, hemoglobin (Hb), hematocrit (Hct) and TG, but negatively correlated with HDL-C. PTX success group postoperative serum leptin increased value and increased body weight, Hb, Hct and decreased blood iPTH value was positively correlated with the surgery did not succeed in the above-mentioned changes. CONCLUSIONS: There is no difference in serum leptin levels between CKD stage 5 patients and healthy subjects, but they are associated with abnormal bone mineral metabolism, hematopoiesis and nutrition in patients with CKD. Successful PTX elevates serum leptin and correlates with the above mentioned indexes.