不同通量透析联合卫生连锁系统治疗对血清Hepcidin水平的影响及临床意义  

Effect of Different Flux Dialysis Uniting Health Interlocking System Treatment on Serum Hepcidin Levels and its Clinical Significance

作　　者：杨晓春[1] 王国才[1] 刘宝玲[1] 杨慧洁[1] 张晓暄[1] 

机构地区：[1]吉林大学第四医院肾内科,长春130011

出　　处：《中国中西医结合肾病杂志》2015年第12期1068-1071,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：吉林省自然科学基金资助项目(No.201115118)

摘　　要：目的:观察不同通量透析联合卫生连锁系统治疗对维持性血液透析(MHD)患者血清Hepcidin水平的影响并分析其相关因素。方法:MHD患者67例,FX高通量透析组(FXHFHD)34例,低通量透析组(LFHD)33例,联合卫生连锁系统治疗18个月。分别于0月、18个月采血,检测血红蛋白、血清白蛋白、尿素、肌酐、二氧化碳结合力、血钙、血无机磷、甲状旁腺素、超敏C反应蛋白、铁蛋白、血清Hepcidin。采用Pearson相关分析和多元回归方法分析血清Hepcidin与其他指标的相关性。结果:联合卫生连锁系统治疗18个月后,两组血清Hepcidin水平均低于0月(P<0.05);FXHFHD组血清白蛋白升高(P<0.05),血磷、甲状旁腺素明显升高(P<0.01)。两组超敏C反应蛋白明显下降(P<0.05)。Pearson相关分析显示,Hepcidin与年龄、铁蛋白、超敏C反应蛋白呈正相关(r=0.450、P<0.01,r=0.596、P<0.01,r=0.676、P<0.01);与血红蛋白、白蛋白、肌酐、血磷呈负相关(r=-0.267、P<0.01,r=-0.493、P<0.01,r=-0.214、P<0.05,r=-0.200、P<0.05)。多元回归显示,联合卫生连锁系统治疗的FXHFHD和LFHD患者的铁蛋白、超敏C反应蛋白水平与血清Hepcidin水平密切相关(R2=0.762,P<0.01)。结论:Hepcidin水平既可以反映铁储备情况,更可以反映机体微炎症状态。联合卫生连锁系统治疗可以降低Hepcidin水平,改善MHD患者的微炎症状态。低通量或FX高通量透析对Hepcidin的影响相似。Objective： To investigate the effect of different flux dialysis uniting health interlocking system treatment in patients with maintenance hemodialysis（ MHD） on serum Hepcidin level and to analyze its related factors. Methods： Sixty- seven MHD patients were enrolled. FX high flux dialysis（ FXHFHD） group of 34 cases,low flux dialysis（ LFHD） group of 33 cases,united health interlocking system treatment for 18 months. Hemoglobin,serum albumin,urea,creatinine,carbon dioxide binding force,serum calcium,serum inorganic phosphorus,parathyroid hormone,hypersensitive C- reactive protein,ferritin and serum hepcidin were assayed at 0 month,18 months respectively. Pearson correlation and multiple stepwise regression methods were used to analyze the relationship between serum hepcidin and other indicators. Results： After uniting health interlocking system treatment for 18 months,both groups of serum hepcidin levels are lower than 0 month（ P 0. 05）; Elevated serum albumin was found in FXHFHD group（ P 0. 05） and serum phosphorus,parathyroid hormone also increased significantly（ P 0. 01）. Hypersensitive C- reactive protein in both groups decreased obviously（ P 0. 05）. Pearson correlation analysis showed that serum hepcidin was positively correlated with age,ferritin and hypersensitive C- reactive protein（ r = 0. 450,P 0. 01; r = 0. 596,P 0. 01; r = 0. 676,P 0. 01）,and was negatively correlated with hemoglobin,albumin,creatinine,phosphorus（ r = 0. 267,P 0. 01; r = 0. 493,P 0. 01; r =0. 214,P 0. 05; r = 0. 200,P 0. 05）. In multiple regression analysis,ferritin and hs- CRP levels are closely associated with serum hepcidin level in patients with FXHFHD and LFHD uniting health interlocking system treatment（ R2= 0. 762,P 0. 01）.Conclusion： Hepcidin level can reflect the iron storage and body micorinflammatory status. Uniting health chain system treatment can improve the microinflammatory status of MHD patients. Low and FX high flux dialysis had similar effects on Hepcidin.

关 键 词：HEPCIDIN 血液透析 FX高通量透析 炎症 

分 类 号：R692.5[医药卫生—泌尿科学]