维持性血液透析患者血清Irisin、MBL与炎症因子和动静脉内瘘血栓形成的关系研究  

Study on the Relationship between Serum Irisin,MBL and Inflammatory Factors and Arteriovenous Fistula Thrombosis in Maintenance Hemodialysis Patients

作　　者：陈敏 张珊珊 张国欣 许静 薛兰芬 CHEN Min;ZHANG Shan-shan;ZHANG Guo-xin;XU Jing;XUE Lan-fen(Department of Nephrology,Shijiazhuang People's Hospital,Shijiazhuang,Hebei,050031,China)

机构地区：[1]石家庄市人民医院肾内科,河北石家庄050031

出　　处：《现代生物医学进展》2024年第6期1067-1071,1037,共6页Progress in Modern Biomedicine

基　　金：河北省科技计划项目(162777234)。

摘　　要：目的:探讨维持性血液透析(MHD)患者血清鸢尾素(Irisin)、甘露糖结合凝集素(MBL)与炎症因子和动静脉内瘘(AVF)血栓形成的关系。方法:选取2021年1月~2022年10月石家庄市人民医院收治的125例MHD患者为MHD组,根据是否合并血栓形成分为血栓形成组41例和无血栓形成组84例,另选取我院同期85名体检健康者为对照组。采用酶联免疫吸附法检测血清Irisin、MBL和炎症因子[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)]水平。通过Spearman相关性分析MHD患者血清Irisin、MBL与炎症因子水平的相关性,多因素Logistic回归分析MHD患者AVF血栓形成的影响因素,受试者工作特征(ROC)曲线分析血清Irisin、MBL对MHD患者AVF血栓形成的预测效能。结果:与对照组比较,MHD组血清Irisin水平降低,MBL、IL-1β、IL-6、TNF-α水平升高(P<0.05)。Spearman相关性分析显示,MHD患者血清Irisin与IL-1β、IL-6、TNF-α水平呈负相关,MBL与IL-1β、IL-6、TNF-α水平呈正相关(P<0.05)。多因素Logistic回归分析显示,透析龄延长和血小板计数、D-二聚体、TNF-α、MBL升高为MHD患者AVF血栓形成的独立危险因素,Irisin升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清Irisin、MBL联合预测MHD患者AVF血栓形成的曲线下面积(AUC)为0.826,大于单一指标预测。结论:MHD患者血清Irisin水平降低和MBL升高,与炎症因子升高和AVF血栓形成有关,血清Irisin、MBL联合对MHD患者AVF血栓形成的预测效能较高。Objective:To investigate the relationship between serum Irisin,mannose-binding lectin(MBL)and inflammatory factors and arteriovenous fistula(AVF)thrombosis in maintenance hemodialysis(MHD)patients.Methods:125 MHD patients who were admitted to Shijiazhuang People's Hospital from January 2021 to October 2022 were selected as MHD group,patients were divided into thrombosis group(41 cases)and non-thrombosis group(84 cases)according to the presence or absence of thrombosis,and 85 healthy people who underwent physical examination in our hospital during the same period were selected as control group.The levels of serum Irisin,MBL and inflammatory factors[interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α)]were detected by enzyme-linked immunosorbent assay.The correlation between serum Irisin,MBL and inflammatory factors in MHD patients were analyzed by Spearman correlation,the influencing factors of AVF thrombosis in MHD patients were analyzed by multivariate Logistic regression,the predictive efficacy of serum Irisin and MBL on AVF thrombosis in MHD patients were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with control group,the serum Irisin level in the MHD group was decreased,and the levels of MBL,IL-1β,IL-6 and TNF-αwere increased(P<0.05).Spearman correlation analysis showed that,serum Irisin was negatively correlated with IL-1β,IL-6 and TNF-αlevels in MHD patients,and MBL was positively correlated with IL-1β,IL-6 and TNF-αlevels(P<0.05).Multivariate logistic regression analysis showed that the prolonged dialysis age was extendedand,the increased platelet count,D-dimer,TNF-α,and MBL were independent risk factors for AVF thrombosis in MHD patients,and increased Irisin was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum Irisin and MBL combined to predict AVF thrombosis in MHD patients was 0.826,which was greater than that predicted by a single index.Conclusion:The decrease of serum Irisin level and the increase of M

关 键 词：维持性血液透析 鸢尾素 甘露糖结合凝集素 炎症因子 动静脉内瘘 血栓形成 

分 类 号：R459.5[医药卫生—治疗学]