血液透析联合血液透析滤过清除维持性血液透析患者铁调素研究  

Research of hemodialysis combined with hemodiafiltration in removing hepcidin in maintenance hemodialysis patients

作　　者：张晨[1] 周光宇[1] 

机构地区：[1]中国医科大学附属盛京医院肾内科,沈阳110000

出　　处：《中国综合临床》2017年第5期437-440,共4页Clinical Medicine of China

摘　　要：目的 比较维持性血液透析患者单纯血液透析和血液透析联合血液透析滤过治疗后血清铁调素、血红蛋白和其他指标变化,探讨血液透析联合血液透析滤过清除维持性血液透析患者血清铁调素,改善贫血的作用及两者的关系.方法 选择 2015年1月至2017年2月中国医科大学附属盛京医院血液净化中心22例患者,并做自身对照研究.入组前患者均为行单纯规律血液透析的患者,入组后给予患者血液透析联合血液透析滤过治疗3个月,比较单纯血液透析（即治疗前）和血液透析联合血液透析滤过治疗3个月后血清铁调素、血红蛋白、网织红细胞百分比、铁蛋白、血清铁、转铁蛋白饱和度和促红细胞生成素 （EPO）变化,并对血清铁调素及其他指标进行相关性分析.结果 血液透析联合血液透析滤过治疗3个月后,患者血清铁调素（77.61＆#177;3.31） μg/L较单纯血液透析时（89.49＆#177;7.87） μg/L显著下降（t=9.660,P〈0.01）,血红蛋白水平（112.73＆#177;11.02） g/L较前（88.32＆#177;11.83） g/L提高（t=-11.957,P〈0.01）.血清铁调素与血红蛋白呈负相关（r=-0.851,P〈0.01）,与铁蛋白呈正相关（r=0.385,P〈0.05）;与网织红细胞百分比（r=-0.151,P=0.328）、血清铁（r=0.123,P=0.427）、转铁蛋白饱和度（r=0.211,P=0.170）、EPO（r=-0.173,P=0.261）无关.结论 与单纯血液透析相比,血液透析联合血液透析滤过治疗能更有效清除铁调素并改善贫血,且两者有相关性.Objective To compare the changes of serum hepcidin,hemoglobin and other indexes of pure hemodialysis and hemodialysis combined with hemodiafiltration in treatment of maintenance hemodialysis patients,and to investigate the effect of hemodialysis combined with hemodiafiltration therapy on serum hepcidin clearance,the improvement of anemia and the relationship between them of maintenance hemodialysis patients.Methods Twenty-two patients with maintenance hemodialysis patients were collected from Shengjing Hosphal Affiliated to China Medical University from January 2015 to February 2017.This study was self-controlled study,before enrollment all patients were given only regular hemodialysis,after enrollment all patients were given hemodialysis combined with hemodiafiltration therapy for 3 months,compared the changes of serum hepcidin,hemoglobin,reticulocyte percentage,ferritin,serum iron,transferrin saturation and EPO of pure hemodialysis（before treatment） and hemodialysis combined with hemodiafiltration treatment for 3 months of patients,and analyzed the correlationship between serum hepcidin and other indexes.Results After hemodialysis combined with hemodiafiltration therapy for 3 months,compared with pure hemodialysis serum hepcidin levels were significantly lower（（77.61＆#177;3.31） μg/L vs.（89.49＆#177;7.87） μg/L,t=9.660,P〈0.01）,hemoglobin levels were increased（（112.73＆#177;11.02） g/L vs.（88.32＆#177;11.83） g/L,t=-11.957,P〈0.01）.The correlations between serum hepcidin and other indexes show that serum hepcidin and hemoglobin and ferritin were related,serum hepcidin was negatively correlated with hemoglobin（r=-0.851,P〈0.01）and positively correlated with ferritin（r=0.385,P〈0.05）,and found no correlations between hepcidin and reticulocyte percentage（r=-0.151,P=0.328）,serum iron（r=0.123,P=0.427）,transferrin saturation（r=0.211,P=0.170） and EPO（r=-0.173,P=0.261）.Conclusion To compare with pure hemodialysis,hemodialysis combined with hemodiafiltration the

关 键 词：铁调素 血液透析 血液透析滤过 铁代谢 贫血 

分 类 号：R459.7[医药卫生—急诊医学]