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目的:探讨低白蛋白血症对腹膜透析患者血清脂联素和炎症状态的影响。方法:入选86例持续性非卧床腹膜透析患者,以血清白蛋白35 g.L-1为界分为血清白蛋白正常组(A组)和血清白蛋白降低组(B组),并设健康对照组(C组),检测脂联素和肿瘤坏死因子α等指标。结果:3组间BMI比较,P>0.05,差异无统计学意义;A组和B组脂联素和肿瘤坏死因子α水平明显高于C组,经F检验,P<0.01;B组脂联素水平低于A组,P<0.01;B组肿瘤坏死因子α水平高于A组,P<0.01,两组比较差异具有统计学意义;相关分析显示:腹膜透析患者血清白蛋白水平与脂联素水平呈正相关r,=0.49,P<0.01,与肿瘤坏死因子α水平呈负相关r,=-0.52,P<0.01;腹膜透析患者脂联素水平与肿瘤坏死因子α水平呈负相关r,=-0.56,P<0.01。结论:腹膜透析患者营养不良导致的低白蛋白血症可加重炎症状态,降低血清脂联素水平,这可能是该类患者营养不良、慢性炎症、心血管事件综合征发生的原因之一。
Objective: To investigate the effect of hypoalbuminemia on serum adiponectin and inflammatory status in peritoneal dialysis patients. Methods: Eighty-six patients who underwent continuous ambulatory peritoneal dialysis were divided into serum albumin normal group (A group) and serum albumin reduced group (B group) by serum albumin 35 g L-1, and healthy control group (C group), detect adiponectin and tumor necrosis factor alpha and other indicators. Results: There was no significant difference in BMI between the three groups (P> 0.05). The levels of adiponectin and tumor necrosis factor alpha in group A and group B were significantly higher than those in group C (P <0.01) The level of TNF-α in group B was higher than that in group A (P <0.01), and the difference was statistically significant between the two groups. The correlation analysis showed that serum albumin level in peritoneal dialysis patients was significantly higher than that in group A There was a positive correlation between serum adiponectin level and tumor necrosis factor α (r = 0.49, P <0.01), negative correlation with tumor necrosis factor α (r = 0.52, P <0.01) = -0.56, P <0.01. Conclusion: Hypoalbuminemia caused by malnutrition in peritoneal dialysis patients may aggravate the inflammatory state and lower the level of serum adiponectin, which may be one of the causes of malnutrition, chronic inflammation and cardiovascular syndrome in these patients.