腹膜透析患者铁调素表达变化及与肾性贫血、微炎性反应的相关性分析

The relationship of hepcidin level with renal anemia and micro- inflammation status in peritoneal dialysis patients

目的探讨体内铁稳态平衡调节分子铁调素（hepeidin）在腹膜透析（PD）患者中的表达变化，以及铁调素与肾性贫血、机体微炎性反应之间的相关性。方法采用酶联免疫法（ELISA）测定50例PD贫血患者、30例PD无贫血患者和40例健康对照者的血清铁调素、白细胞介素6（IL-6）、可溶性转铁蛋白受体（sTfR）和红细胞生成素（EPO）的水平，同时检测血常规、血生化和铁代谢等指标，并进行相关性分析。结果铁调素在PD患者中表达高于健康对照组[（103．65±43．6）μg/L比（56．39±35．7）μg／L，P〈0．05]，而且PD贫血组铁调素表达高于无贫血组[（122．67±36．6）μg／L比（83．65±26．4）μg/L，P〈0．05]。PD患者的铁调素表达与IL-6、sTIR、EPO、血清铁蛋白呈正相关（R=0．821、0．742、0．711、0．531，P〈0．05）；与24h残肾肌酐清除率、血红蛋白呈负相关（R=-0．533、-0．685，P〈0．05）。结论PD患者体内铁调素水平升高，与机体残余肾功能、微炎性反应有关。铁调素水平升高导致体内铁代谢失衡，与肾性贫血有关，通过对铁调素的影响，为改善PD患者的肾性贫血和微炎性反应提供临床研究意义。

Objective To observe the level of serum hepcidin and the relationship of hepeidin with renal anemia and micro- inflammation state in peritoneal dialysis（PD） patients. Methods Serum hepcidin, interleukin-6（IL-6）, soluble transferrin receptor （sTfR） and erythropoietin （EPO） were measured in 50 PD patients with anemia, 30 PD patients without anemia and 40 cases of normal control by ELISA. The indexes of blood routine examination, biochemistry and iron metabolism were also detected at the same time. Results The level of hepcidin in PD patients was significantly higher than that in normal control[（103.65±43.6） μg/L vs （56.39±35.7） μg/L, P 〈 0.05]. Furthermore, the level of hepcidin in PD patients with anemia was higher than that in PD patients without anemia [（122.67±36.6） p.g/L vs （83.65±26.4） μg/L, P 〈 0.05]. The results of correlation analysis showed that serum IL-6, sTfR, EPO and ferritin were positively correlated with hepeidin（R = 0.821, 0.742, 0.711, 0.531 , all P 〈 0.05 ）, while creatinine clearance of residual kidney in 24 hours and hemoglobin were negatively correlated with hepcidin（R =-0.533,-0.685, all P 〈 0.05 ）. Conclusions The higher level of hepcidin in PD patients is related with the residual renal function and the micro-inflammatory state. The higher level of hepcidin may induce the iron metabolism imbalance, and then influence the state of renal anemia. The adjustment of hepcidin may provide clinical research value of improving renal anemia and micro-inflammatory state in PD patients.