红细胞磷脂酰丝氨酸外露在腹膜透析患者贫血中的意义初探

The role of erythrocytes phosphatidylserine exposure in anemia in peritoneal dialysis patients

目的探讨腹膜透析患者红细胞磷脂酰丝氨酸(PS)外露在贫血发生中的作用。方法选择北京大学第一医院67例临床稳定的腹膜透析患者。采用荧光标记的AnnexinV方法结合流式细胞仪测定红细胞PS外露水平,并分析其与贫血的关系。结果多元Logistic回归分析提示红细胞PS外露水平是贫血发生的危险因素之一(Hazardsratio=-0.421,P<0.05)。偏相关分析提示红细胞PS外露水平与血红蛋白水平呈负相关(r=-0.2601,P<0.05)(控制促红细胞生成素因素)。结论红细胞磷脂酰丝氨酸外露增加是腹膜透析患者贫血发生的危险因素,红细胞磷脂酰丝氨酸外露水平越高,患者越容易出现贫血。

Objective Although an increased red blood cell （RBC） phosphatidylserine （PS） exposure in uremic patients was found which could promote macrophage recognition and decrease RBC survival time, the role of RBC phosphatidylserine exposure in anemia is unknown. In the present study, we investigated the role of PS exposure of erythrocytes in the development of anemia in peritoneal dialysis patients. Methods Sixty-seven peritoneal dialysis patients were included in the present study. A flow-cytometric assay based on FITC-Annexin V was used to measure the PS exposure of erythrocytes. The relationship between PS exposure and anemia was analyzed. Results Logistic regression analysis revealed that percentage of PS-positive RBCs was identified as a risk factor for anemia （Hazards ratio=-0.421, P〈0.05）. An inverse correlation was found between percentage of PS-positive RBCs and hemoglobin concentration （r=-0.2601, P〈 0.05） after adjustment of erythropoietin dosage. Conclusion This study suggested that elevated PS exposure in erythrocytes was a risk factor for anemia and might contribute to the development of anemia in peritoneal dialysis patients.