CKD5期患者微炎症状态和HGB水平的关联分析:一项横断面研究  

Correlation analysis between microinflammation status and HGB levels in patients with CKD stage 5:a cross-sectional study

作　　者：刘萍 张淑瑛[2] 邵小南[3] 蒋丽娟[3] LIU Ping;ZHANG Shu-ying;SHAO Xiao-nan(Department of Geriatrics,the Third Affiliated Hospital of Soochow University Changzhou,Jiangsu Changzhou 213003)

机构地区：[1]苏州大学附属第三医院老年科,江苏常州213003 [2]苏州大学附属第三医院检验科,江苏常州213003 [3]苏州大学附属第三医院核医学科,江苏常州213003

出　　处：《医学检验与临床》2021年第12期25-32,共8页Medical Laboratory Science and Clinics

摘　　要：目的:探讨慢性肾脏病5期(Chronic kidney disease stage 5,CKD5)患者微炎症状态[血清降钙素原(Procalcitonin,PCT)水平]与血红蛋白(Hemoglobin,HGB)之间的关联.方法:回顾性分析2017年2月~2019年7月在我院肾内科住院的非感染CKD5期患者共189例.按照患者的PCT水平(ng/mL)三等分为Tertile 1(0.010~0.257)、Tertile 2(0.266~0.502)和Tertile 3(0.514~5.450)三组,每组63例患者,收集患者的一般信息及相关实验室检查结果.结果:单因素Logistic回归分析发现,透析方式、透析年份、谷丙转氨酶、尿素氮、肌酐、白蛋白、总胆固醇、低密度脂蛋白、铁蛋白均为HGB可能的相关因素(P均<0.10).在充分调整协变量后,随着PCT的升高,HGB逐渐降低(β=-2.217;95%CI:-3.999--0.435;P=0.017).对三分组的PCT水平,PCT的升高趋势与HGB的降低显著相关(β=-9.004;95%CI:-17.713--0.295;P=0.046),尤其在T3比T1(β=-11.228;95%CI:-20.819--1.637;P=0.026).曲线拟合显示PCT水平与HGB呈线性负相关(自由度=1,P=0.017).采用分层分析后发现二者的关联性不受年龄分组(<60比≥60岁)和是否糖尿病的影响(交互效应P值分别为0.431和0.521).结论:CKD5期患者的微炎症状态与HGB水平呈线性负相关,本研究对CKD5期患者微炎症状态的评估及肾性贫血的治疗有一定的指导意义.Objective:To explore the relationship between the micro-inflammatory state[serum procalcitonin(PCT)level]and hemoglobin(HGB)in patients with chronic kidney disease stage 5(CKD5).Methods:A total of 189 non-infected CKD stage 5 patients who were hospitalized in the nephrology department of our hospital from February 2017 to July 2019 were retrospectively analyzed.According to the PCT level(ng/mL)of the patients,they were divided into three groups:Tertile 1(0.010-0.257),Tertile 2(0.266-0.502)and Tertile 3(0.514-5.450).There are 63 patients in each group,and general information of patients and relevant laboratory test results are collected.Results:Single factor logistic regression analysis found that dialysis method,dialysis year,alanine aminotransferase,urea nitrogen,creatinine,albumin,total cholesterol,low-density lipoprotein,and ferritin are all possible related factors of HGB(all P<0.10).After fully adjusting the covariates,with the increase of PCT,HGB gradually decreased(β=-2.217;95%CI:-3.9999--0.435;P=0.017).For the three groups of PCT levels,the increasing trend of PCT was significantly correlated with the decrease of HGB(β=-9.004;95%CI:-17.713--0.295;P=0.046),especially at T3 vs.T1(β=-11.228;95%CI:-20.819--1.637;P=0.026).Curve fitting showed that the PCT level was linearly negatively correlated with HGB(degrees of freedom=1,P=0.017).After stratified analysis,it was found that the correlation between the two was not affected by age grouping(<60 vs.≥60 years)and whether or not diabetes(the interaction effect P value was 0.431 and 0.521,respectively).Conclusion:The microinflammatory state of CKD5 patients is linearly negatively correlated with HGB levels.This study has certain guiding significance for the evaluation of the microinflammatory state of CKD5 patients and the treatment of renal anemia.

关 键 词：慢性肾脏病5期 微炎症状态 血红蛋白 关联分析 

分 类 号：R44[医药卫生—诊断学]