摘要
目的:观察维持血液透析(HD)患者在纠正代谢性酸中毒后血清瘦素(Leptin)浓度及一些营养指标的变化。方法:用酶联免疫吸附(ELISA)方法,测定40例HD前血清Leptin浓度,对其中20例血气分析提示代谢性酸中毒的HD患者,予口服碳酸氢钠,比较治疗前后血清Leptin浓度变化,将Leptin与体重指数(BMI)、血清碳酸氢盐、血浆胰岛素、血浆全段甲状旁腺素(iPTH)及其他生化指标作相关分析。设对照组和健康对照组,各组均以性别再分组。结果:HD患者血清Leptin男组(5.987±5.708)μg/L,与BMI正相关(P<0.05),女组(8.081±4.524)μg/L,与BMI无相关性。酸中毒组治疗后Leptin、胰岛素略升,血脂代谢也有一定程度的改善,但无统计学差异(P>0.05)。酸中毒的HD患者血清Leptin与碳酸氢盐、胰岛素i、PTH、白蛋白、血脂等均无相关性。男、女两组Leptin均与健康对照组和无酸中毒组比较无统计学差异(P>0.05)。结论:纠正代谢性酸中毒后HD患者营养状况有所改善,血清瘦素浓度无显著变化。
Objective：To investigate the effect of metabolic acidosis on serum leptln and nutrition and explore its clinical significance. Methods ：,Serum leptin concentrations, fasting plasma insulin and blood gas were measured in 40 patients （24 males in group Ⅰ and 16 females in group Ⅱ） on HD. 20 patients（ 13 males, group A and 7 females, group B） with metabolic acidosis were observed before and after 5 - 10days of oral sodium bicarbonate （NaHCO3） treatment. Fasting plasma insulin and intact parathyroid hormone （iPTH） were determined by radioimmunoassay. Serum HCO3^ -, albumin （Alb）, triglyceride（TG）, highdensity lipoproteincholesterol（ HDL- C）, very lowdensity lipoprotein cholesterol （VLDL- C）, creatinine（Cr）, ionized calcium（Ca^2± ） and glucose（BS） were examined. BMⅠ was also calculated. 20 HD patients with normal acid - base balance（group C） and 22 healthy volunteer were used as control. Results： （ 1 ） Serum leptin was positively correlated with BMⅠ and BMⅠ had a positive correlation with HCO3^- （P〈0.05） in group Ⅰ. （2）Serum leptin of uremia patients was slightly increased （group A 5. 230 ± 3. 636 vs 7.113 ± 2. 846 ng/ml, P = 0.119; group B 9.916 ± 3,757 vs 11.42 ± 4. 537 ng/ml, P = 0. 504） after improvement of metabolic acidosis. Serum leptin level in group A and B had no significant differences when compared with group C and normal control（P 〉0.05）. Fasting plasma insulin was slightly elevated in group A and B. HDL- Ch increased in group A . TG and LDL- Ch declined in group B. （3） Ⅰn group A and B, Serum leptin level had no correlation with HCO3^-, insulin,Alb, HDL- C, iPTH, etc. Conclusion：Correction of metabolic acidosis results in the variation of protiein and lipid and contributes to the improvement of nutritional status of ESRD patients on HD. The improvement of metabolic acidosis has no significant influence on the serum leptin.
出处
《中国中西医结合肾病杂志》
2005年第12期709-712,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
汕头市科技局基金资助项目(No.[2002]97号)
