老年患者炎症因子水平与肾性贫血的相关分析

Correlation of anemia, inflammatory factors and renal function in the elderly

目的 探讨老年患者贫血的发生与炎症因子水平及。肾功能的相关性。方法 选择老年患者（年龄≥60岁）200例为研究对象，另设30例健康体检者为正常对照组。根据血红蛋白水平将200例老年患者分为贫血组和非贫血组；根据估算肾小球滤过率（eGFR）又分为A组[eGFR〉50ml·min^-1·（1．73m^2）^-1]、B组[eGFR30～50ml min^-1·（1．73m^2）^-1和C组[eGFR〈30mlmin^-1·（1．73m^2）^-1]，测定血清超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）水平。结果随着肾功能水平减退，贫血患病率逐渐增高，血清hs-CRP、IL-6、TNF-α水平亦逐渐增高，但仅hs-CRP组间有显著差异（P〈0．05）；血清hs-CRP、IL-6、TNF-α与血红蛋白均呈负相关（r=-0．271、-0．148、-0．155，P〈0．05）；hs-CRP、TNF-α与eGFR亦呈负相关（r=-0．140、-0．142，P〈0．05），IL-6与eGFR无相关性。结论老年人肾功能减退时的高贫血患病率与炎症因子参与的致病机制有关；hs-CRP在评价。肾功能减退者的机体炎症状态时优于TNF-α和IL-6。

Objective To explore the correlation of anemia, inflammatory factors and renal function in the elderly. Methods 200 elderly patients（≥60 years old） were enrolled in the research, and 30 healthy individuals served as the control group. According to hemoglobin levels, the elderly patients were firstly divided into anemia group and non-anemia group; then these patients were redivided into three subgroups according to eGFR levels：group A [eGFR〉50 ml·min^-1· （1.73 m^2 ）^-1], group B [eGFR 30-50 ml·min^-1·（1.73 m^2 ）^-1] and group C [eGFR〈30 ml·min^-1·（1.73 m^2 ）^-1]. Serum hs- CRP, IL-6, and TNF-α levels were measured. Results With the deterioration of renal function, the prevalence of anemia was increased, and the levels of hs-CRP, IL-6 and TNF-α were elevated, but only the level of hs-CRP had significant difference among groups A, B and C（P〈0. 05）. There was a strong negative association of the serum hs-CRP, IL-6 and TNF-α levels with hemoglobin（r = - 0. 271, - 0. 148, - 0. 155, respectively, P〈0. 05）. The levels of hs-CRP and TNF-a were negatively correlated with eGFR （r = -0. 140, -0. 142, respectively, P〈0. 05）, while there was no correlation between IL- 6 and eGFR. Conclusions The high prevalence of anemia in the elderly whose renal function was dete- riorated is related to pathogenic mechanism of inflammatory factors. In assessing inflammatory status of patients with renal function damage,hs-CRP is superior to TNF-α and IL-6.