COPD患者血清hepcidin、sTfR测定在贫血并发症中的应用价值研究

The detection of hepcidin and sTfR in COPD with anemia patients and its clinic significance

目的检测慢性阻塞性肺疾病(COPD)伴发贫血患者血清中铁调节素(hepcidin)和血清转铁蛋白受体(ser-um transfer-ring receptor,sTfR)的表达变化,探讨其在COPD相关性贫血中的作用。方法收集我院2008年12月～2010年12月收治的COPD患者104例,其中COPD贫血患者24例,COPD非贫血患者80例,另取在本院体检中心健康体检者30例作为对照组。ELISA检测受试者血清hepcidin和sTfR的表达水平。结果 COPD患者中贫血的发病率为23.1%(24/104)。对照(A)组、COPD(B)组和COPD合并贫血(C)组hepcidin的表达水平分别为21.33±5.26、29.46±8.57和41.02±11.34ng/mL,各组间存在显著性差异(F=8.64,P<0.05);A、B和C组中sTfR的表达水平分别为19.21±3.77、27.68±5.72和37.94±8.61nmol/L,各组间亦存在显著性差异(F=7.58,P<0.05);其中C组中hepcidin和sTfR的表达水平均显著高于B组(P<0.05)。轻度、中度和重度组COPD伴发贫血患者hepci-din的表达水平分别为35.42±6.24、42.31±7.44和51.23±12.144ng/mL,各组间存在显著性差异(F=7.64,P<0.05);上述各组中sTfR的表达水平分别为32.27±5.68、40.74±6.46和47.32±9.84nmol/L,各组间亦存在显著性差异(F=7.42,P<0.05)。相关性分析显示血清hepcidin表达水平与患者的血红蛋白水平呈负相关(r=-0.574,P<0.05),血清sTfR表达水平亦与患者的血红蛋白水平呈负相关(r=-0.535,P<0.05),血清hepcidin和sTfR的表达水平呈正相关(r=0.686,P<0.01)。结论 COPD患者hepcidin的升高所导致的机体可利用铁减少可能是COPD相关性贫血的主要成因,Hepcidin有望成为COPD相关性贫血的一个新的治疗靶点,或者是疗效的监控指标。。

Objective To observe the clinical significance of hepcidin and serum transfer-ring receptor（sTfR） in patients with chronic obstructive pulmonary disease（COPD） related anemia.Methods A total of 104 patients with COPD were enrolled in this study.24 COPD patients were diagosed as anemia.30 healthy person were used as a normal control.The expression of hepcidin and sTfR in serum was detected by ELISA analysis.Results The prevalence of anemia COPD was 23.1%（24/104）.The level of hepcidin in serum was 21.33±5.26,29.46±8.57,and 41.02±11.34 ng/mL in control（A）group,COPD（B）group and COPD associated anema（C）group,respectively.Significant difference of hepcidin level was found between the three groups（F=8.64,P〈0.05）.The level of sTfR in serum was 19.21±3.77,27.68±5.72,and 37.94±8.61 nmol/L in A,B,and C group,respectively.Significant difference of hepcidin level was found between the three groups（F=7.58,P〈0.05）.The expression of hepcidin in low,medium,and high anema patients were 35.42±6.24,42.31±7.44,and 51.23±12.144 ng/mL,respectively.Significant difference was found between the three groups（F=7.64,P〈0.05）.The expression of sTfR in low,medium,and high anema patients were 32.27±5.68,40.74±6.46,47.32±9.84 nmol/L,respectively.Significant difference was found between the three groups（F=7.42,P〈0.05）.The level of hepcidin in serum was negatively related with Hb level（r=-0.574,P〈0.05）.The level of sTfR in serum was also negatively related with Hb level（r=-0.535,P〈0.05）.The level of hepcidin was positively related with sTfR level（r=0.686,P〈0.05）.Conclusion The high-level expression of hepcidin play a key role in the development of COPD-related anemia.Hepcidin may be used as a new target to treat COPD patients with anemia.