维持性血液透析患者高瘦素血症与动脉粥样硬化的关系

首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (3): 378-381.

维持性血液透析患者高瘦素血症与动脉粥样硬化的关系

王银娜, 刘惠兰, 姚英, 刘群

首都医科大学附属复兴医院肾脏内科

收稿日期:2006-02-27 修回日期:1900-01-01 出版日期:2007-06-24 发布日期:2007-06-24

The Role of Hyperleptinemia on Atherosclerosis in Patients with Maintenance Hemodialysis

Wang Yinna, Liu Huilan, Yao Ying, Liu Qun

Department of Nephrology, Fu Xing Hospital, Capital Medical University

Received:2006-02-27 Revised:1900-01-01 Online:2007-06-24 Published:2007-06-24

摘要/Abstract

摘要： 目的研究维持性血液透析患者血清瘦素(Leptin)水平与颈动脉粥样硬化及动脉舒张功能的关系。方法选择维持性血液透析患者50例和年龄性别相当的健康对照者30例,采用双抗体夹心酶联免疫吸附(ABC-ELISA)技术检测血清瘦素水平,用高分辨二维颈动脉超声技术检测颈动脉内-中膜厚度(IMT)、粥样硬化斑块、肱动脉内径及反应性充血后肱动脉内径的变化。结果无论男性或女性血液透析患者血清瘦素水平均明显高于相应的正常对照组(P<0.01),透析患者平均IMT值、IMT增厚率和颈动脉粥样斑块检出率明显高于对照组,肱动脉反应性充血后内径增加率明显低于正常对照组(P<0.01)。多因素逐步回归分析显示,血清瘦素水平是影响IMT和反应性充血后肱动脉内径变化率的独立危险因素。结论血清瘦素与血透患者的动脉粥样硬化病变及肱动脉舒张功能障碍有关,可能是加速其动脉粥样硬化的危险因素。

关键词: 瘦素, 维持性血液透析, 动脉粥样硬化

Abstract: Objective To investigate the correlation between serum leptin and atherosclerosis and arterial vasodilation in maintenance hemodialysis patients.Methods Fifty maintenance hemodialysis patients and thirty healthy volunteers were enrolled in the study.The levels of serum leptin were determined with enzyme linked immunosorbent assay.Intima-media thickness(IMT) and prevalence atherosclerotic plaques of the extracranial common carotid artery were measured with high-resolution B-mode ultrasonography.The changes in brachial artery diameter during reactive hyperemia were analyzed with ultrasonic examination.Results Both men and women serum leptin levels in hemodialysis patients were significantly higher than those in healthy controls(men(6.13±2.41)μg/L vs(3.25±1.98)μg/L;women(8.98±3.12)μg/L vs(5.79±2.01)μg/L,(P<0.01)).Compared with those in controls,the mean IMT value,percentage of thickened IMT and prevalence of atherosclerotic plaques in hemodialysis patients were significantly increased,while the changes in brachial artery diameter during reactive hyperemia were significantly decreased(P<0.01).Multiple stepwise regression analysis showed that serum leptin was an independent risk factor associated with IMT and changes in brachial artery diameter during reactive hyperemia.Conclusion The level of serum leptin in patients with maintenance hemodialysis is associated with the development of atherosclerosis and dysfunction of arterial vasodilation.Hyperleptinemia may be an independent risk factor for atherosclerosis in patients with maintenance hemodialysis.

Key words: leptin, maintenance hemodialysis, atherosclerosis

中图分类号:

R692.5

王银娜;刘惠兰;姚英;刘群. 维持性血液透析患者高瘦素血症与动脉粥样硬化的关系[J]. 首都医科大学学报, 2007, 28(3): 378-381.

Wang Yinna;Liu Huilan;Yao Ying;Liu Qun. The Role of Hyperleptinemia on Atherosclerosis in Patients with Maintenance Hemodialysis[J]. Journal of Capital Medical University, 2007, 28(3): 378-381.

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