血清白细胞介素-6、白细胞介素-2、肿瘤坏死因子-α与尿毒症脑病的关系  

Associations of serum interleukin-6,interleukin-2,and tumor necrosis factor-αwith uremic encephalopathy

作　　者：李雅琦 邓晓风 杨卫民 LI Yaqi;DENG Xiaofeng;YANG Weimin(Department of Nephrology and Rheumatology,Jinyang Hospital Affiliated to Guizhou Medical University,Guiyang 550081,Guizhou,China;School of Clinical Medicine,Guizhou Medical University,Guiyang 550025,Guizhou,China)

机构地区：[1]贵州医科大学附属金阳医院肾病风湿科,贵州贵阳550081 [2]贵州医科大学临床医学院,贵州贵阳550025

出　　处：《贵州医科大学学报》2025年第2期261-267,共7页Journal of Guizhou Medical University

基　　金：贵阳市科技计划项目(筑科合同[2019]9-9-4)。

摘　　要：目的探讨患者血清白细胞介素-6(interleukin-6,IL-6)、IL-2、肿瘤坏死因子-α(tumor necrosis factor,TNF-α)与尿毒症脑病(uremic encephalopathy,UE)的相关性及影响UE进展的独立危险因素。方法选择2021年12月—2023年6月在贵州医科大学附属金阳医院就诊的UE患者73例(观察组)及慢性肾脏病(chronic kidney disease,CKD)5期患者78例(对照组)为研究对象,收集所有患者的年龄、性别、吸烟史、高血压史、糖尿病史、是否合并代谢性酸中毒和血肌酐(serum creatinine,Scr)、血红蛋白(hemoglobin,Hb)、白蛋白(albumin,ALB)及甲状旁腺激素(parathormone,PTH)水平等资料,通过ELISA法检测研究对象血清IL-6、IL-2、TNF-α水平,并比较两组患者间的差异,再将差异有统计学意义的因素纳入单因素及多因素logistic回归模型筛选出UE的危险因素。结果与对照组比较,观察组患者血清IL-6、IL-2、TNF-α升高,差异有统计学意义(P<0.05),且血Scr与IL-6、IL-2、TNF-α的表达呈正相关(P<0.05);多因素logistic回归分析显示,Scr、Hb≤90 g/L、ALB≤30 g/L、PTH、代谢性酸中毒、IL-6、IL-2、TNF-α是CKD患者发生UE的独立危险因素(P<0.05)。结论血清中IL-6、IL-2和TNF-α的高表达、血Scr、Hb≤90 g/L、ALB≤30 g/L、PTH及代谢性酸中毒均是CKD患者发生UE的独立危险因素。Objective To investigate the correlations of the expressions of serum interleukin-6(IL-6),IL-2,and tumor necrosis factor(TNF-α)with uremic encephalopathy(UE)as well as independent risk factors of UE progression.Methods A total of 73 patients with UE(observation group)and 78 patients with stage 5 chronic kidney disease(CKD,control group)in Jinyang Hospital Affiliated to Guizhou Medical University from December 2021 to June 2023 were selected as research subjects.All patients were collected for age,gender,smoking history,hypertension history,diabetes history,whether metabolic acidosis was merged,serum creatinine(Scr),hemoglobin(Hb),albumin(ALB),and parathyroid hormone(PTH),etc.ELISA was applied to detect the levels of serum IL-6,IL-2,and TNF-α,which were further compared for their differences between two groups in order to screen out the factors with statistically significant differences,then incorporated into univariate and multivariate logistic regression models to identify the risk factors for UE.Results The levels of serum IL-6,IL-2,and TNF-αwere significantly higher in observation group than those in control group(P<0.05),and serum creatinine was positively correlated with the expressions of IL-6,IL-2,and TNF-α(P<0.05).Multivariate logistic regression analysis showed that Scr,Hb≤90 g/L,ALB≤30 g/L,PTH,metabolic acidosis,IL-6,IL-2,and TNF-αwere independent risk factors for UE occurrence in the patients with CKD(P<0.05).Conclusion High expression of serum IL-6,IL-2 and TNF-α,serum Scr,Hb≤90 g/L,ALB≤30 g/L,PTH,and metabolic acidosis are independent risk factors for UE occurrence in the patients with CKD.

关 键 词：尿毒症脑病 微炎症状态 白细胞介素-6 白细胞介素-2 肿瘤坏死因子-Α 

分 类 号：R692.5[医药卫生—泌尿科学]