糖尿病肾病患者贫血与肾功能、微炎性状态的相关性分析  

Correlation analysis of anemia with renal function and micro-inflammatory state in patients with diabetic nephropathy

作　　者：王琼[1] 朱燕亭 闫晓辉[1] 张琳萍[1] 丁通[1] Wang Qiong;Zhu Yanting;Yan Xiaohui;Zhang Linping;Ding Tong(Renal Disease Hemodialysis Center, Shaanxi Provincial People's Hospital, Shaanxi Province ,Xi' an 710068,China)

机构地区：[1]陕西省人民医院肾病血透中心,西安710068

出　　处：《疑难病杂志》2022年第6期609-612,618,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省自然科学基金项目(2021JQ-905);陕西省人民医院科技人才支持计划项目(2021JY-31)。

摘　　要：目的分析糖尿病肾病(DN)患者贫血与肾功能、微炎性状态的相关性。方法选取2019年9月—2021年10月陕西省人民医院肾病血透中心收治DN患者160例,根据是否贫血分为贫血组112例和非贫血组48例,比较2组的临床资料、血红蛋白(Hb)、肾功能指标[胱抑素C(Cys C)、尿素氮(BUN)]、炎性指标[肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、IL-10]、免疫功能指标[免疫球蛋白G(IgG)、IgM],采用Pearson相关法分析DN患者Hb水平与肾功能、炎性反应和免疫功能指标的相关性。结果贫血组的糖尿病病程长于非贫血组,肾病分期Ⅱ~Ⅳ期比例高于非贫血组,Hb水平低于非贫血组[t(χ^(2))/P=4.828/<0.001、24.346/<0.001、18.331/<0.001];BUN、CysC和TNF-α、IL-8、IL-10水平高于非贫血组(t/P=4.100/0.001、3.380/0.001、16.221/<0.001、12.733/<0.001、7.999/<0.001);IgG、IgM水平低于非贫血组(t/P=13.574/<0.001、6.490/<0.001);DN患者Hb水平与BUN、CysC、TNF-α、IL-8、IL-10呈负相关(r/P=-0.623/<0.001、-0.615/<0.001、-0.464/0.003、-0.638/<0.001、-0.520/0.001),与IgG、IgM呈正相关(r/P=0.475/0.002、0.523/0.001)。结论DN贫血患者肾功能、免疫功能减退,微炎性状态明显,Hb水平与肾功能、炎性反应和免疫功能指标存在一定相关性。Objective To analyze the correlation of anemia with renal function and micro-inflammatory state in patients with diabetic nephropathy(DN).Methods From September 2019 to October 2021,160 patients with DN admitted to the Nephropathy Hemodialysis Center of Shaanxi Provincial People's Hospital were selected,and they were divided into 112 cases of anemia group and 48 cases of non-anemia group according to whether they were anemia or not.The clinical data,hemoglobin(Hb),renal function indexes[cystatine C(Cys C),blood urea nitrogen(BUN)],inflammatory indexes[tumor necrosis factor alpha(TNF-α),interleukin-8(IL-8),IL-10],and inflammatory indexes were compared between the two groups.Immune function indicators[immunoglobulin G(IgG),IgM].Pearson correlation method was used to analyze the correlation between Hb level and renal function,inflammatory response and immune function in DN patients.Results The duration of diabetes in the anemia group was longer than that in the non-anemia group,the ratio of gradeⅡ-Ⅳnephropathy was higer than non-anemia group,and the Hb level was lower than that in the non-anemia group(t/P=4.828/<0.001,24.346/<0.001,18.331/<0.001).The levels of BUN,CysC,TNF-α,IL-8,and IL-10 were higher than those in the non-anemia group(t/P=4.100/0.001,3.380/0.001,16.221/<0.001,12.733/<0.001,7.999/<0.001).The levels of IgG and IgM were lower than those of the non-anemia group(t/P=13.574/<0.001,6.490/<0.001).The level of Hb in DN patients was negatively correlated with BUN,CysC,TNF-α,IL-8,and IL-10(r/P=-0.623/<0.001,-0.615/<0.001,-0.464/0.003,-0.638/<0.001,-0.520/0.001),was positively correlated with IgG and IgM(r/P=0.475/0.002,0.523/0.001).Conclusion The renal function and immune function of patients with DN anemia are decreased,and the micro-inflammatory state is obvious.There is a certain correlation between Hb level and renal function,inflammatory response and immune function indicators.

关 键 词：糖尿病肾病 贫血 肾功能 微炎性状态 免疫功能 相关性 

分 类 号：R556[医药卫生—血液循环系统疾病] R587.2[医药卫生—内科学]