摘要
目的探讨非透析慢性肾功能衰竭（ＣＲＦ）患者的营养状况。方法对２０例ＣＲＦ患者胰岛素样生长因子Ⅰ（ＩＧＦⅠ）等生化指标进行了测定。ＩＧＦⅠ采用酶联免疫法（ＥＬＩＳＡ）。结果非透析ＣＲＦ患者血清ＩＧＦⅠ明显低于正常人（１７６２±９２５μｇ／Ｌ与２６６７±１０１７μｇ／Ｌ，Ｐ＜００１）。转铁蛋白水平明显低于正常人（２５７±０５８ｇ／Ｌ与３１８±０２７ｇ／Ｌ，Ｐ＜００１）。血清白蛋白＜４００ｇ／Ｌ患者（７／２０）的ＩＧＦⅠ水平明显低于血清白蛋白≥４００ｇ／Ｌ患者（９５６±４２４μｇ／Ｌ与２１９６±８２７μｇ／Ｌ，Ｐ＜００１）。α酮酸治疗患者ＩＧＦⅠ水平高于非酮酸治疗患者。ＩＧＦⅠ水平与肌酐清除率呈明显正相关（ｒ＝０７０６６，Ｐ＜００１），与转铁蛋白水平呈明显正相关（ｒ＝０５３４７，Ｐ＜００５）。结论（１）营养不良在ＣＲＦ患者相对常见，可通过测定血清ＩＧＦⅠ、转铁蛋白、白蛋白等进行监测。（２）血清ＩＧＦⅠ与血清转铁蛋白及肾功能具有较好的相关性，是评价ＣＲＦ患者营养状况的良好指标。（３）非透析ＣＲＦ患者血清ＩＧＦⅠ水平明显低于正常，正规营养治疗的非透析ＣＲＦ?
Objective In order to understand the nutritional status of nondialytic patients with chronic renal failure (CRF), nutritional status was assessed in 20 nondialytic patients (M∶F 15∶5, mean age 43.7±15.1 years). Methods Serum insulin like growth factor Ⅰ (IGF Ⅰ) was measured with ELISA method. Meanwhile, other serum biochemical parameters were also determined. Results Mean IGF Ⅰ and transferrin levels in CRF patients were significantly lower than those in normal subjects (176.2±92.5 μg/L vs 266.7±101.7 μg/L, P <0.01; 2.57±0.58 g/L vs 3.18±0.27 g/L, P <0.05). IGF Ⅰ level in patients with serum albumin<40.0 g/L (7/20) was significantly lower than that in patients with serum albumin ≥40.0 g/L (95.6±42.4 μg/L vs 219.6±82 7 μg/L, P <0.01). IGF Ⅰ level in cases treated with ketoacid (α KA) was higher than that in those without α KA treatment. Meanwhile, IGF Ⅰ level was positively correlated with Ccr ( r =0.7066, P <0 01) and serum transferrin ( r =0.5347, P <0.05). Conclusion (1) Malnutrition was relatively common in nondialytic patients, the nutritional status can be assessed by measureing IGF Ⅰ, transferrin and albumin. (2) Serum IGF Ⅰ correlated with serum transferrin and Ccr. It is suggested that IGF Ⅰ may be a good indicator for assessing nutritional status of CRF patients. (3) Serum IGF Ⅰ level in patients before dialysis is probably lower than that in normal subjets. IGF Ⅰ level in CRF patients may be improved by nutritional therapy.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第9期608-611,共4页
Chinese Journal of Internal Medicine
关键词
肾功能衰竭
慢性
营养
胰岛素
生长因子
Kidney failure
chronic
Nutritional status
Receptors
insulin like growth factor
