终末期肾功能衰竭患者血液透析后HO-1、IL-6、IL-18的变化及其与透析效果的关系  

Study on the changes of HO-1,IL-6 and IL-18 in patients with end-stage renal disease after hemodialysis and their relationship with dialysis effect

作　　者：胡春艳 牛聪 陈文龙 Hu Chunyan;Niu Cong;Chen Wenlong(Dialysis Room,the First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学第一附属医院透析室,河南开封475000

出　　处：《感染、炎症、修复》2024年第4期307-311,共5页Infection Inflammation Repair

基　　金：河南省医学科技攻关计划项目(No.2018020323)。

摘　　要：目的:探讨血清血红素氧化酶-1(HO-1)、白细胞介素(IL)-6、IL-18在终末期肾功能衰竭(ESRD)患者血液透析前后的水平变化及其与血液透析效果的关系。方法:回顾性分析2020年1月至2021年3月在河南大学第一附属医院血液净化中心实施血液透析的82例ESRD患者的临床资料,并设为观察组,另选取同期在同一医院进行体检的70名健康人群为对照组。比较两组一般资料、HO-1、IL-6、IL-18水平,观察观察组血液透析效果,分析影响血液透析效果的相关因素,计算HO-1、IL-6、IL-18单独及联合检测对血液透析效果的预测效果。结果:观察组透析前HO-1水平高于对照组,透析后又明显升高(P<0.05);观察组IL-6、IL-18水平透析前显著高于对照组,透析后虽然明显下降,但仍显著高于对照组(P<0.05)。82例ESRD患者中,透析充分组61例与透析不充分组21例的年龄、透析期间出现低血压者百分比、透析器凝血者百分比、HO-1、IL-6、IL-18水平比较,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,年龄>60岁、透析期间出现低血压、透析器凝血、低HO-1水平、高IL-6和IL-18水平是影响血液透析效果的独立危险因素(P<0.05)。HO-1、IL-6、IL-18三者联合预测血液透析结果的AUC为0.854,灵敏度、特异度分别为0.943、0.924,高于HO-1、IL-6、IL-18单独检测(P<0.05)。结论:在血液透析前联合检测ESRD患者血清HO-1、IL-6、IL-18水平,可为预测血液透析进而制订治疗方案提供可靠依据。Objective:To investigate the changes in serum levels of heme oxygenase-1(HO-1),interleukin-6(IL-6),and IL-18 before and after hemodialysis in patients with end-stage renal disease(ESRD)and their relationship with hemodialysis effect.Methods:A retrospective analysis of 82 ESRD patients who underwent hemodialysis in the blood purification center of the First Affiliated Hospital of Henan University from January 2020 to March 2021 were selected as the observation group,and 70 healthy people who underwent physical examination in the same hospital during the same period were selected as the control group.The general data,HO-1,IL-6,and IL-18 levels of the two groups were compared.The hemodialysis effect of the observation group was observed.The related factors affecting hemodialysis effect were analyzed.Also,the prediction effect of HO-1,IL-6 and IL-18 alone and combined detection on the hemodialysis effect was calculated.Results:The level of HO-1 in the observation group was higher than that in the control group before dialysis,and increased significantly after dialysis(P<0.05).The levels of IL-6 and IL-18 in the observation group were significantly higher than those in the control group before dialysis,and decreased significantly after dialysis,but were still significantly higher than those in the control group(P<0.05).Among the 82 patients with ESRD,61 cases in the adequate dialysis group and 21 cases in the inadequate dialysis group had statistically significant differences in age,percentage of hypotension during dialysis,percentage of hemodialyzer coagulation,HO-1,IL-6 and IL-18 levels during dialysis(P<0.05).Binary logistic regression analysis showed that age more than 60 years old,hypotension during dialysis,dialyzer coagulation,low HO-1,high IL-6 and IL-18 levels were independent risk factors affecting the effectiveness of hemodialysis(P<0.05).The AUC of HO-1,IL-6,and IL-18 combined predicted hemodialysis results was 0.854,with sensitivity and specificity of 0.943 and 0.924,respectively,which was higher than the

关 键 词：肾功能衰竭 终末期 血液透析 血红素氧化酶-1 白细胞介素-6 白细胞介素-18 

分 类 号：R692.5[医药卫生—泌尿科学]