SF/RBC、TSAT、EPO与MHD炎症-营养关系及预测感染效能  

The relationship between SF/RBC,TSAT,EPO and MHD inflammation-nutrition and its efficacy in predicting infection

作　　者：张琼果 胡基杨 莫芳妮 李莉 ZAHNG Qiong-guo;HU Ji-yang;MO Fang-ni;LI Li(Blood Purification Center,The First Affiliated Hospital of Hainan Medical University,Haikou 570100;Clinical Laboratory,The First Affiliated Hospital of Hainan Medical University,Haikou 570100;Clinical Laboratory,Hainan Province Hospital of Traditional Chinese Medicine,Haikou,570100,China)

机构地区：[1]海南医学院第一附属医院血液净化中心,海南海口570100 [2]海南医学院第一附属医院检验科,海南海口570100 [3]海南省中医院检验科,海南海口570100

出　　处：《生物技术》2021年第3期286-293,278,共9页Biotechnology

基　　金：海南省卫生计生行业科研项目(18A200051)。

摘　　要：[目的]探究铁蛋白(SF)/血红细胞计数(RBC)、转铁蛋白饱和度(TSAT)、促红细胞生成素(EPO)与维持性血液透析(MHD)患者炎症-营养状态的关联性及预测细菌感染的效能。[方法]选取2017年4月~2019年11月我院收治的86例MHD细菌感染患者(感染组)、86例MHD无感染患者(无感染组)及体检中心86例人群(对照组),比较3组炎症状态指标[C反应蛋白(CRP)、白介素-6(IL-6)]、营养状态指标[血红蛋白(Hb)、白蛋白]、SF/RBC、TSAT、EPO,并对数据进行统计学分析。[结果]感染组SF/RBC(146.67±18.32)高于无感染组(90.88±17.19)、对照组(52.68±14.18),且无感染组高于对照组(P<0.05);感染组TSAT[(23.46±3.39)%],EPO[(3.02±2.19)mU/mL]低于无感染组[(27.69±4.13)%,(6.11±2.35)mU/mL],对照组[(32.48±2.77)%,(9.78±3.01)mU/mL],且无感染组低于对照组(P<0.05);SF/RBC与CRP(r=0.773,P<0.001),IL-6(r=0.770,P<0.001)呈正相关,TSAT与CRP(r=-0.844,P<0.001),IL-6(r=-0.734,P<0.001)呈负相关,EPO与CRP(r=-0.553,P<0.001),IL-6(r=-0.703,P<0.001)呈负相关;SF/RBC、TSAT、EPO与白蛋白无相关(P>0.05);SF/RBC与Hb呈负相关(r=-0.625,P<0.001),TSAT与Hb呈正相关(r=0.707,P<0.001),EPO与Hb呈正相关(r=0.508,P<0.001);将年龄、性别、体质量指数、透析时间等因素控制后,SF/RBC、TSAT、EPO仍与炎症-营养状态(MIS评分)相关(P<0.05);单一指标中,EPO预测MHD细菌感染的AUC最大(0.839),联合预测AUC为0.905,95%CI为0.864~0.947,P<0.05,大于任一指标。[结论]SF/RBC、TSAT、EPO与MHD患者炎症-营养状态有关,SF/RBC>112.48、TSAT≤25.73%、EPO≤4.89 mU/mL时对并发细菌感染具有一定的预测价值。[Objective]To explore the relationship between serum ferritin(SF)/red blood cell count(RBC),transferrin saturation(TSAT),erythropoietin(EPO)and maintenance hemodialysis(MHD)patients with inflammation-nutrition status and the efficacy of predicting bacterial infection.[Method]From April 2017 to November 2019,86 MHD patients with bacterial infection(infection group),86 MHD patients without infection(non-infection group)and 86 people from the physical examination center(control group)were selected.The inflammatory status indicators[C-reactive protein(CRP),interleukin-6(IL-6)],nutritional status indicators[hemoglobin(Hb),albumin],SF/RBC,TSAT,EPO of the three groups were compared.Pearson was used to analyze the correlation between SF/RBC,TSAT,EPO and inflammation-nutritional status in MHD patients,and Logistic regression equation was used to analyze the related factors of MHD bacterial infection.The receiver operating characteristic(ROC)curve and the area under the ROC(AUC)were used to analyze the efficacy of SF/RBC,TSAT,and EPO in predicting bacterial infection,And the data were analyzed statistically.[Result]The SF/RBC(146.67±18.32)of the infection group was higher than that of the non-infection group(90.88±17.19)and the control group(52.68±14.18),and the non-infection group was higher than the control group(P<0.05).TSAT[(23.46±3.39)%],EPO[(3.02±2.19)mU/mL]in the infected group were lower than[(27.69±4.13)%,(6.11±2.35)mU/mL]in the non-infection group,[(32.48±2.77)%,(9.78±3.01)mU/mL]in the control group,and the non-infected group was lower than the control group(P<0.05).SF/RBC was positively correlated with CRP(r=0.773,P<0.001),IL-6(r=0.770,P<0.001),TSAT was negatively correlated with CRP(r=-0.844,P<0.001),IL-6(r=-0.734,P<0.001),EPO was negatively correlated with CRP(r=-0.553,P<0.001),IL-6(r=-0.703,P<0.001).There was no correlation between SF/RBC,TSAT,EPO and albumin(P>0.05).SF/RBC was negatively correlated with Hb(r=-0.625,P<0.001),TSAT and Hb were positively correlated(r=0.707,P<0.001),EPO was positively c

关 键 词：维持性血液透析 铁蛋白 血红细胞计数 转铁蛋白饱和度 促红细胞生成素 炎症-营养状态 细菌感染 

分 类 号：R692.5[医药卫生—泌尿科学]