维持性血液透析患者血清HMGB1、PCT、IL-1β、IL-6水平的变化及对预后的影响  

Changes of serum HMGB1,PCT,IL-1β,and IL-6 levels in patients undergoing maintenance hemodialysis and their influence on prognosis

作　　者：王杰 刘伟 王霞 李燕燕 WANG Jie;LIU Wei;WANG Xia;LI Yan-yan(Department of Nephrology,the Second People's Hospital of Jiaozuo City,Jiaozuo 454000,Henan,CHINA;Department of Clinical Laboratory,the Second People's Hospital of Jiaozuo City,Jiaozuo 454000,Henan,CHINA;Department of Breast and Thyroid Surgery,the Second People's Hospital of Jiaozuo City,Jiaozuo 454000,Henan,CHINA)

机构地区：[1]焦作市第二人民医院肾内科,河南焦作454000 [2]焦作市第二人民医院检验科,河南焦作454000 [3]焦作市第二人民医院甲乳科,河南焦作454000

出　　处：《海南医学》2025年第6期808-811,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20230909)。

摘　　要：目的探讨维持性血液透析(MHD)患者血清高迁移率蛋白1(HMGB1)、降钙素原(PCT)、白介素水平变化及其临床意义。方法回顾性分析2020年4月至2023年4月焦作市第二人民医院收治的210例MHD患者的临床资料,将45例合并导管相关性感染(CRI)者作为感染组,165例未合并CRI者作为未感染组,根据1个月内的MHD治疗结果将患者分为预后良好组(n=170)和预后不良组(n=40)。比较各组患者的血清HMGB1、PCT、白介素-1β(IL-1β)、白介素-6(IL-6)水平,采用Pearson相关分析法分析MHD患者血清HMGB1、PCT、IL-1β、IL-6水平与CRI及预后的相关性。结果感染组患者的血清HMGB1、PCT、IL-1β及IL-6水平分别为(140.68±15.02)μg/L、(8.34±0.90)ng/mL、(45.45±2.07)ng/L、(58.28±3.10)ng/L,明显高于非感染组的(4.14±0.54)μg/L、(0.35±0.11)ng/mL、(25.68±2.00)ng/L、(33.01±3.04)ng/L,差异均有统计学意义(P<0.05);预后不良组患者的血清HMGB1、PCT、IL-1β、IL-6水平分别为(160.05±20.13)μg/L、(12.15±1.30)ng/mL、(56.46±1.33)ng/L、(65.60±4.20)ng/L,均高于预后良好组患者的(10.20±1.25)μg/L、(2.03±0.85)ng/mL、(22.71±1.25)ng/L、(32.40±4.24)ng/L,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,MHD患者血清HMGB1、PCT、IL-1β、IL-6水平与CRI均呈正相关(r=0.993、0.991、0.971、0.960,P<0.05),MHD患者血清HMGB1、PCT、IL-1β、IL-6水平与预后也均呈正相关(r=0.989、0.973、0.983、0.951,P<0.05)。结论血清HMGB1、PCT、IL-1β、IL-6水平在MHD合并CRI患者中的表达明显升高,联合检测有助于早期诊断和监测CRI,从而改善患者的预后。Objective To investigate the changes of serum high mobility protein 1(HMGB1),procalcitonin(PCT),and interleukin in patients undergoing maintenance hemodialysis(MHD)and their clinical significance.Methods The medical records of 210 patients undergoing MHD admitted to the Second People's Hospital of Jiaozuo City from April 2020 to April 2023 were retrospectively analyzed.Forty-five patients with catheter-related infection(CRI)were selected as the infected group,and 165 patients without CRI were selected as the non-infected group.According to the outcome of MHD treatment(within 1 month),patients were divided into a good prognosis group(n=170)and a poor prognosis group(n=40).Serum levels of HMGB1,PCT,interleukin-1β(IL-1β),and interleukin-6(IL-6)were compared between the two groups,and the correlation between serum levels of HMGB1,PCT,IL-1β,IL-6 and CRI,prognosis in MHD patients was analyzed by Pearson correlation analysis.Results The serum levels of HMGB1,PCT,IL-1β,and IL-6 in the infected group were(140.68±15.02)μg/L,(8.34±0.90)ng/mL,(45.45±2.07)ng/L,and(58.28±3.10)ng/L,which were significantly higher than(4.14±0.54)μg/L,(0.35±0.11)ng/mL,(25.68±2.00)ng/L,(33.01±3.04)ng/L in non-infected group(P<0.05).The serum HMGB1,PCT,IL-1β,and IL-6 levels of patients in the poor prognosis group were(160.05±20.13)μg/L,(12.15±1.30)ng/mL,(56.46±1.33)ng/L,and(65.60±4.20)ng/L,respectively,which were significantly higher than(10.20±1.25)μg/L,(2.03±0.85)ng/mL,(22.71±1.25)ng/L,and(32.40±4.24)ng/L of patients in the good prognosis group(P<0.05).Pearson correlation analysis showed that serum levels of HMGB1,PCT,IL-1β,and IL-6 in MHD patients were positively correlated with CRI(r=0.993,0.991,0.971,0.960,P<0.05)and also positively correlated with prognosis(r=0.989,0.973,0.983,0.951,P<0.05).Conclusion The serum HMGB1,PCT,IL-1β,and IL-6 levels were significantly increased in MHD patients with CRI,and combined detection of the four indexes was helpful for early diagnosis and monitoring of CRI,thereby improving the pro

关 键 词：维持性血液透析 导管相关性感染 高迁移率蛋白1 降钙素原 白介素-1Β 白介素-6 预后 

分 类 号：R459.5[医药卫生—治疗学]