维持性血液透析患者微量元素与微炎症状态的相关性分析  

Association between blood trace elements and micro-inflammatory state in maintenance hemodialysis patients

作　　者：李子源 刘云[1,2] 谭荣韶[2] 钟小仕 刘岩[1,2] LI Zi-yuan;LIU Yun;TAN Rong-shao;ZHONG Xiao-shi;LIU Yan(Department of Nephrology,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China;Institute of Disease-Oriented Nutritional Research,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学附属广州红十字会医院肾内科,广州510220 [2]暨南大学附属广州红十字会医院临床病态营养研究所,广州510220

出　　处：《中国血液净化》2022年第7期492-496,共5页Chinese Journal of Blood Purification

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者全血微量元素与微炎症状态(micro-inflammatory state)之间的关系。方法采用单中心横断面研究,纳入2019年9月暨南大学附属广州红十字会医院血液净化中心行规律MHD的患者,收集受试者的人口学和临床资料,测定透析前血常规、血清生化指标和全血微量元素铜、锌、锰、铅、硒(电感耦合等离子体质谱仪法)。根据血清超敏C反应蛋白(hs-CRP)水平分为微炎症状态组(hs-CRP 3~15mg/L)和对照组(hs-CRP<3mg/L),比较2组临床特征。应用Spearman相关分析和二元Logistic回归评价与MHD患者微炎症状态相关的因素。结果共纳入128例MHD患者,其中微炎症状态组65例,对照组63例,Spearman相关分析提示hs-CRP、IL-6与全血铜水平呈正相关(r=0.530、0.427,均P<0.001)。在校正相关混杂因素后,多因素二元Logistic回归显示全血铜升高(OR=1.008,95%CI:1.004~1.012,P<0.001)和全血铜≥810.60μg/L组(OR=7.406,95%CI:3.080~17.807,P<0.001)是MHD患者微炎症状态的独立相关因素。结论MHD患者全血铜水平升高与微炎症状态独立相关,值得引起临床工作者的重视并有必要加强对该患者全血铜水平的随访监测。Objectives To investigate the association between blood trace elements and micro-inflammatory state in maintenance hemodialysis(MHD)patients.Method This was a single-center and cross-sectional study.Patients undergoing MHD within September,2019 in our center were enrolled in this study.Demographic,clinical data and blood samples were collected before hemodialysis session.Routine blood tests,serum biochemical parameters and blood trace elements were measured.According to hs-CRP level,patients were divided into micro-inflammatory state group(hs-CRP 3~15mg/L)and control group(hs-CRP<3mg/L).Spearman analyses and binary logistic regression were performed to study the relationship between blood trace elements and micro-inflammatory state.Results A total of 128 MHD patients were enrolled in this study,including 65 patients in the micro-inflammatory state group and 63 patients in the control group.Spearman analyses showed that the levels of serum hs-CRP and IL-6 were positively correlated with the blood copper level(r=0.530 and 0.427,respectively;P<0.001).Multivariate logistic regression showed that elevated level of blood copper and blood copper≥810.60μg/L were independently associated with the micro-inflammatory state(OR=1.008,95%CI:1.004~1.012,P<0.001;OR=7.406,95%CI:3.080~17.807,P<0.001).Conclusion Elevated blood copper was independently associated with the micro-inflammatory state in MHD patients,indicating the necessity of blood copper monitoring in MHD patients.

关 键 词：全血铜 微炎症状态 维持性血液透析 

分 类 号：R459.5[医药卫生—治疗学]