不同血液净化方式对CRF患者血清PTH、leptin和Hcy水平的影响被引量：1

Effect of Different Types of Blood Purification Treatment (HD and HDF) on the Serum PTH,Leptin and Hcy Levels in Patients with Chronic Renal Failure

暂未订购

导出

摘要目的:探讨不同净化方式对慢性肾衰(CRF)患者血清甲状旁腺素(PTH)、瘦素(leptin)和同型半胱氨酸(Hcy)水平的影响。方法:选择维持性血液透析患者60例,随机分成2组:血液透析(HD)组30例,血液透析滤过(HDF)组30例。检测治疗前后血清PTH、leptin和Hcy水平。结果:维持性血液透析患者HDF组治疗后血清PTH从(60.8±32.5)pmol/L降至(28.2±17.2)pmol/L,治疗前后比较有显著性差异(P<0.01);leptin从(19.7±11.8)μg/L降至(14.1±10.6)μg/L,治疗前后比较有显著性差异(P<0.05);Hcy从(32.3±10.7)μmol/L降至(21.1±8.9)μmol/L,治疗前后比较有显著性差异(P<0.01)。HD组治疗后血清PTH从(61.6±30.8)pmol/L降至(42.2±16.5)pmol/L,治疗前后比较有显著性差异(P<0.05);leptin从(19.3±12.1)μg/L降至(18.9±12.3)μg/L治疗前后比较无显著性差异(P>0.05);Hcy从(31.5±10.5)μmol/L降至(20.4±8.5)μmol/L,治疗前后比较有显著性差异(P<0.01)。结论:HDF组与HD组相比较能更好地清除PTH及leptin。 Objective To investigate the effect of different type of blood purification treatment（hemodialysis and hemodiafiltration） on the serum PTH,Leptin and Hcy levels in patients with chronic renal failure（CRF）.Methods Serum levels of PTH（with ECLIA）,Leptin（with RIA） and Hcy（with biochemistry） were measured in 30 patients treated with hemodialysis（HD） and 30 patients treated with hemodiafiltration（HDF） both before and after treatment.Results The concentration of PTH decreased significantly from 60.8±32.5pmol/L to 28.2±17.2pmol/L in patients treated with HDF（P〈0.01）.The concentration of leptin significantly decreased from（19.7±11.8） μg/L to（14.1±10.6） μg/L（P〈0.05）and the concentration of Hcy also decreased significantly from 32.3±10.7μmol/L to 21.1±8.9μmol/L（P〈0.01） in patients treated with HDF.The concentration of PTH decreased significantly from 61.6±30.8pmol/L to 42.2±16.5pmol/L in patients treated with HD（P〈0.05）.The concentration of leptin decreased only in significantly from（19.3±12.1）μg/L to（18.9±12.3）μg/L（P〉0.05）.Yet the concentration of Hcy also decreased significantly from 31.5±10.5μmol/L to 20.4±8.5μmol/L（P〈0.01） in patients treated HD.Conclusion HDF can eliminate serum PTH,leptin and Hcy better than HD does.

作者姚永良

机构地区江苏省昆山市第一人民医院

出处《放射免疫学杂志》 CAS 2009年第6期582-584,共3页 Journal of Radioimmanology

关键词慢性肾功能衰竭血液透析血液透析滤过甲状旁腺素瘦素同型半胱氨酸 chronic renal failure（CRF） hemodialysis（HD） hemodiafiltration（HDF） parathyroid hormone（PTH） leptin homocysteine（Hcy）

分类号 R589.2 [医药卫生—内分泌] R448 [医药卫生—诊断学]

引文网络
相关文献

参考文献11

1程海邹作君陈建民等.高通量透析对甲状旁腺素的清除效果.中国血液净化,2000,1(3):186-7.
2Sharma K, Considine RV, Michael B, et al. Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients[ J]. Kidney Int, 1997,51:1980-1985.
3Nordfors L, Lonnqvist F, Heimburger O, et al. Low leptin gene expression and hyperlepfinemia in chronic renal failure [ J ]. Kidney Int, 1998,54(4) :1267-1275.
4张宝清,陈永生,赵月霞,王宜海.Leptin RIA在慢性肾功能衰竭的临床意义[J].放射免疫学杂志,2006,19(1):23-24. 被引量：3
5高炜,姜宁,朱国英,孟昭亨,汤键.冠心病患者血浆同型半胱氨酸的变化及其机制的探讨[J].中华医学杂志,1998,78(11):821-823. 被引量：52
6王真,郭静萱,王天成,赵一鸣,毛节明,陈小平.同型半胱氨酸与冠状动脉病变关系的分析[J].中华内科杂志,2000,39(7):443-445. 被引量：36
7Suliman ME, Qureshi AR, Barany P, et al. Hyperhomocysteinemia, nutritional status, and cardiovascular disease in hemodialysis patients[ J]. Kidney Int,2000,57(4) :1727-1733.
8Vuagnat BA, Pierroz DD, Lalaoui M, et al. Evidence for aleptinneuropetlde Y axis for the regulation of growth hormone secretion in the rat [ J]. Neuroendocrinology, 1998,67 (5) :291-300.
9Meyer C, Bobson D, Rackovsky N, et al. Role of the kidney in human leptin metabolism [ J ]. Am J Physiol, 1997,273 ( 5 Pt 1 ) : E903-907.
10Widiaja A, Kielstein JT, Horn R, et al. Free serum leptin but not bound leptin concentrations are elevated in patients with endstage renal disease[ J]. Nephrol Dial Transplant, 2000,15:846-850.

二级参考文献11

1肖创清,何云南.血清瘦素放射免疫分析的临床应用进展(文献综述)[J].放射免疫学杂志,2005,18(5):383-385. 被引量：6
2Zhang Y,Poenca R,Maffei M,et al.Positional cloning of the mouse obese gene and its human homologue.Nature.1994,372:425.
3Halaas JL,Gajiwala KS,Maffei M,et al.Weight-reducing effects of the plasma protein encoded by the obese gene.Science.1995,269:543.
4Cohen B,Novik D,Rubinstein M,et al.Modulation of insulin activites by leptin.Science.1996,274:1.
5Merabet E,Dagogo-Jack S,Coyne DW,et al.Increased plasma leptin concentration in end-stage renal disease.J Clin Endocrinal Metab.1997,82:847.
6Kolaczynski JW,Nyce MR,Considine RV,et al.Acute and chronic effect of insulin on leptin production in humans:studies in vivo and in vitro.Diabetes.1996,45:699.
7Shek EW,Brands MW,Hall JE.Chronic leptin infusion increases arterial pressure.Hypertension.1998,31:409.
8Lord GM Matarese G,Howard JK,et al.Leptin modulates the T-cell immune response and reverses starvation induced immunosuppression.Nature.1998,349:897.
9Sharma K,Considine RV,Michael B,et al.Plasma leptin is partly cleared by the kidney and is elevated in hemodialysis patients.Kidney Int.1997,51:1980.
10Daschner M,Tonshoff B,Blum WF,et al.Inappropriate elevation of serum leptin levels in children with chronic renal failure.J Am Soc Nephrol.1998,9:1074.