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目的 探讨血脂联素(ADPN)与尿毒症腹膜透析(腹透)患者炎症及动脉粥样硬化 的关系。方法 采用酶联免疫复合物法测定正常对照组与59例规律性腹透患者血清ADPN水 平,并对这些腹透患者进行为期(10．0±1．7)月的随访。分析血清ADPN水平与血脂、炎症指标、 颈动脉内膜厚度、颈动脉斑块、既往心血管病(CVD)史和心血管预后的关系。结果 与正常对照 组相比,腹透组患者的血清ADPN水平显著升高[(13．09±7．54)μg／ml比(6．65±4．33)μg／ml,P= 0．001]。腹透患者血清ADPN与年龄、体重指数(BMI)、甘油三酯、C-反应蛋白(CRP)水平呈负相 关;与高密度脂蛋白(HDL)呈正相关。血清ADPN水平在有颈动脉斑块及动脉粥样硬化性心血 管疾病病史的腹透患者中较低。在随访期内有CVD事件发生组血清ADPN水平与无CVD事件 发生组相比显著降低。结论 血清ADPN水平与脂代谢异常、炎症和动脉粥样硬化性疾病有关, 血清ADPN较高的患者发生CVD事件的危险性较低。在腹透患者中,ADPN可能具有心血管的 保护作用。
Objective To investigate the relationship between adiponectin (ADPN) and inflammation and atherosclerosis in uremic peritoneal dialysis patients. Methods Serum ADPN levels in normal controls and 59 patients with regular peritoneal dialysis were measured by enzyme-linked immunosorbent assay (ELISA), and the patients with peritoneal dialysis were followed up for a period of (10.0 ± 1.7) months. The relationship between serum ADPN level and blood lipid, inflammation index, carotid intima-media thickness, carotid artery plaque, previous cardiovascular disease (CVD) history and cardiovascular prognosis were analyzed. Results Compared with the normal control group, the level of serum ADPN in patients with peritoneal dialysis increased significantly [(13.09 ± 7.54) μg / ml vs (6.65 ± 4.33) μg / ml, P = 0). 001]. Serum ADPN in patients with peritoneal dialysis was negatively correlated with age, body mass index (BMI), triglyceride and C-reactive protein (CRP), and positively correlated with high density lipoprotein (HDL). Serum ADPN levels are lower in patients with a history of carotid plaque and atherosclerotic cardiovascular disease. There was a significant decrease in serum ADPN levels during the follow-up period when compared with those without CVD events. Conclusions Serum ADPN levels are associated with abnormal lipid metabolism, inflammation and atherosclerotic disease. Patients with higher serum ADPN have a lower risk of CVD events. In peritoneal dialysis patients, ADPN may have a cardiovascular protective effect.