维持性血液透析患者血清全段甲状旁腺素水平与微炎症的关系研究  

Study on the relationship between intact parathyroid hormone and microinflammation in maintain-hemodialysis Patients

作　　者：刘慧敏 李长红[1] 颜嘉仪 刘欣媛 LIU Huimin;LI Changhong;YAN Jiayi;LIU Xinyuan(Department of nephrology,First Affiliated Hospital of Jiamusi University,Jiamusi 154003,China)

机构地区：[1]佳木斯大学附属第一医院肾内科,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2024年第1期13-17,共5页Heilongjiang Medicine and Pharmacy

基　　金：黑龙江省卫生健康委员会科研项目,编号:20210303050050。

摘　　要：目的:探讨维持性血液透析患者全段甲状旁腺素(intact parathyroid hormone,iPTH)与C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)的相关性及微炎症指标之间的相关性。方法:选取佳木斯大学附属第一医院100例维持性血液透析(maintain hemodialysis,MHD)患者依据iPTH水平分为A组(iPTH<300pg/mL)和B组(iPTH≥300pg/mL)。收集两组的基线资料,检测两组生化指标、全段甲状旁腺素、血清hs-CRP、IL-6及TNF-α。40例健康体检人员为对照组。结果:维持性血液透析患者血清中hs-CRP、IL-6、TNF-α、iPTH数值明显高于对照组;B组患者血磷(P)、hs-CRP、IL-6及TNF-α水平明显高于A组患者,差异有统计学意义(P<0.05)。MHD患者中iPTH与hs-CRP、IL-6和TNF-α呈显著正相关;hs-CRP与IL-6、TNF-α呈显著正相关;A组中iPTH与hs-CRP、TNF-α水平呈正相关;B组中iPTH与hs-CRP、TNF-α水平呈正相关。多元回归结果显示hs-CRP显著影响血清iPTH水平。结论:hs-CRP、TNF-α是影响MHD患者iPTH水平的重要因素,它们可能参与了继发性甲状旁腺功能亢进的发生及发展,其中hs-CRP是iPTH的独立影响因素,且微炎症因子之间存在相互影响。Objective:To investigate the correlation between intact parathyroid hormone(iPTH)and C-reactive protein(Hs-CRP),interleukin-6(IL-6),tumor necrosis factorα(TNF-α)and microinflammation in patients with maintenance hemodialysis.Methods:40 normal subjects were selected as normal control group.According to the degree of iPTH,100 patients with maintenance hemodialysis(MHD)were divided into group A(iPTH≤300pg/mL)and group B(iPTH≥300pg/mL).The baseline data of the two groups were collected,the biochemical indexes,whole-segment parathyroid hormone and the levels of serum hs-CRP,IL-6 and TNF-α.Results:The levels of serum inflammatory factors and parathyroid hormone in maintenance hemodialysis patients were significantly higher than those in normal control group.The levels of serum phosphorus(P),hs-CRP,IL-6 and TNF-α in group B were significantly higher than those in group A,and the difference is statistically significant.In patients with MHD,iPTH was positively correlated with hs-CRP,IL-6 and TNF-α,and hs-CRP was positively correlated with IL-6 and TNF-α.In group A,the levels of iPTH were positively correlated with hs-CRP and TNF-α.In group B,the levels of iPTH were positively correlated with hs-CRP and TNF-α.Multiple regression results showed that hs-CRP significantly affected the level of serum iPTH.Conclusion:hs-CRP and TNF-α are important factors affecting the level of iPTH in patients with MHD,and they may participate in the occurrence and development of secondary hyperparathyroidism,in which hs-CRP is an independent factor affecting iPTH,and micro-inflammatory factors influence each other.

关 键 词：维持性血液透析 IPTH HS-CRP IL-6 TNF-α 

分 类 号：R692.5[医药卫生—泌尿科学]