血清肝细胞生长因子水平与血液透析患者蛋白能量消耗的相关性研究  

Correlation between serum hepatocyte growth factor level and protein energy wasting in maintenance hemodialysis patients

作　　者：史聪 李文静[1] 宋培[1] 王天智[1] 刘翠红[1] SHI Cong;LI Wen-jing;SONG Pei(The Third Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第三医院,河北石家庄050000

出　　处：《中国实验诊断学》2020年第6期926-930,共5页Chinese Journal of Laboratory Diagnosis

基　　金：2018年河北省医学科学研究重点课题计划(项目编号20181059)。

摘　　要：目的探讨血清肝细胞生长因子(hepatocyte growth factor,HGF)水平与血液透析患者蛋白能量消耗(protein energy wasting,PEW)的相关性。方法选取本院维持性血液透析治疗的128例终末期肾病(ESRD)患者,观察不同PEW患者临床基础资料及血清HGF水平差异,分析血HGF水平与患者年龄、透析时间、血白蛋白(albumin,Alb)、前白蛋白(proalbumin,PA)、血红蛋白(hemoglobin,Hb)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、C反应蛋白(C-reactive protein,CRP)、白介素-6(interleukin-6,IL-6)的相关性。结果 128例血液透析患者中67例发生PEW,占52.34%。PEW组患者血清HGF、CRP和IL-6水平显著高于非PEW组,BMI、上臂肌围及血Alb、PA、Hb、TC水平明显低于非PEW组(P<0.05)。血液透析患者血HGF水平与BMI、上臂肌围、血Alb、PA、Hb水平均呈显著负相关,与血CRP、IL-6水平呈显著正相关(P<0.05);多因素分析显示,BMI、上臂肌围和血Alb、PA、CRP、IL-6、HGF水平是血液透析患者发生PEW的重要影响因素(P<0.05)。结论维持性血液透析患者发生PEW时血清HGF水平显著升高,HGF水平与患者营养状况、微炎症状态密切相关,HGF可作为判断血液透析患者发生PEW的参考指标。Objective To investigate the correlation between serum hepatocyte growth factor(HGF)level and protein energy wasting in maintenance hemodialysis patients.Methods 128 patients with end-stage renal disease(ESRD)treated by maintenance hemodialysis in our hospital were selected.The differences of serum HGF level and clinical data of patients with different protein-energy expenditure(PEW)were observed.The correlation between serum HGF level and age,dialysis time,serum albumin(Alb),proalbumin(PA),hemoglobin(Hb),total cholesterol(TC),triglyceride(TG),C-reactive protein(CRP),and interleukin-6(IL-6)was analyzed.Results 67 cases(52.34%)of the 128 hemodialysis patients were PEW patients.The serum levels of HGF,CRP and IL-6 in PEW group were significantly higher than those in non-PEW group,while the levels of BMI,upper arm muscle circumference and blood Alb,PA,Hb and TC were significantly lower than those in non-PEW group(P<0.05).HGF level was negatively correlated with BMI,upper arm muscle circumference,Alb,PA and Hb levels,and positively correlated with CRP and IL-6 levels in hemodialysis patients(P<0.05).Multivariate analysis showed that BMI,upper arm muscle circumference,and blood Alb,PA,CRP,IL-6,HGF levels were important influencing factors for the occurrence of PEW in hemodialysis patients(P<0.05).Conclusion Serum HGF levels were significantly increased in maintenance hemodialysis patients with PEW.HGF level is closely related to patients′nutritional status and microinflammatory status,and HGF can be used as a reference index for judging the occurrence of PEW in hemodialysis patients.

关 键 词：维持性血液透析 肝细胞生长因子 蛋白-能量消耗 营养状况 炎症指标 

分 类 号：R692[医药卫生—泌尿科学]