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目的探讨影响腹透液中脂联素(ADPN)和瘦素(LEP)浓度的因素。方法选择稳定腹膜透析3个月以上患者41例,收集临床资料,采用ELISA法测定患者血清和腹透液中ADPN、LEP、转化生长因子-β1(TGF-β1)、胰岛素样生长因子-1(IGF-1)浓度,评估腹透充分性(尿素清楚指数KT/V)和腹膜溶质转运率(PTR),分别根据有无残余肾功能(RRF)、PTR高低进行分组比较,并进行相关性分析和多元线性回归分析。结果 RRF和PTR对腹透患者血清、腹透液ADPN、LEP浓度无影响。多元线性回归分析显示持续性非卧床腹膜透析患者腹透液TGF-β1(R2 change=0.483,P<0.001)、腹膜KT/V(R2 change=0.094,P<0.001)和ADPN独立相关,可以解释57.7%的变异。血清超敏C反应蛋白、IGF-1与腹透液中LEP水平独立相关。结论腹透液中ADPN浓度可能和腹膜慢性炎症反应、腹膜透析效率有关,而腹透液LEP水平可能与炎症、营养不良有关。
Objective To investigate the factors affecting the concentration of adiponectin (ADPN) and leptin (LEP) in peritoneal dialysis fluid. Methods Forty-one patients with stable peritoneal dialysis for more than 3 months were enrolled in this study. The clinical data were collected. The levels of ADPN, LEP, TGF-β1 and insulin-like growth factor-1 (P <0.01), respectively, according to the presence or absence of residual renal function (RRF) and PTR, respectively, according to the concentration of IGF-1 and the adequacy of peritoneal dialysis (KT / V) And multiple linear regression analysis. Results RRF and PTR had no effect on serum and peritoneal dialysis ADPN and LEP concentrations in patients with peritoneal dialysis. Multivariate linear regression analysis showed that peritoneal fluid TGF-β1 (R2 change = 0.483, P <0.001) and peritoneal KT / V (R2 change = 0.094, P <0.001) were independently associated with ADPN in continuous ambulatory peritoneal dialysis patients 57.7% variation. Serum high-sensitivity C-reactive protein, IGF-1 and peritoneal fluid independent of LEP levels. Conclusion The concentration of ADPN in peritoneal dialysis fluid may be related to peritoneal chronic inflammatory reaction and peritoneal dialysis efficiency, while the level of peritoneal fluid LEP may be related to inflammation and malnutrition.