腹膜透析患者血清铁调素25、肿瘤坏死因子α水平和颈动脉粥样硬化的关系

The Relationship Between the Level of Serum Hepcidin-25 and Tumor Necrosis Factor-α and Carotid Atherosclerosis in Peritoneal Dialysis Patients

目的探讨持续性腹膜透析患者血清铁调素25、肿瘤坏死因子α水平和颈动脉粥样硬化程度的关系。方法通过酶联免疫法测定178例维持性腹膜透析患者血清铁调素25水平,采用高分辨二维超声诊断仪对双侧颈总动脉内膜中膜厚度及颈动脉粥样斑块进行测量。结果颈动脉硬化组患者血清铁调素25水平高于无颈动脉硬化组和健康对照组,两组间比较差异均有统计学意义(均P<0.01)。直线相关分析提示血清铁调素25水平与颈动脉内膜中膜厚度呈正相关关系(r=0.685,P=0.001);而且多元逐步回归分析结果发现,血清铁调素25和肿瘤坏死因子α水平是影响颈动脉内膜中膜厚度的独立危险因素。结论血清铁调素25、肿瘤坏死因子α水平均是影响维持性腹膜透析患者颈动脉粥样硬化程度的独立危险因素,可作为动脉粥样硬化预测的危险因子。

Aim To evaluate the relationship between the level of serum hepcidin-25 and tumor necrosis factor-α （TNF-α） and carotid artery atherosclerosis in peritoneal dialysis patients. Methods The serum level of hepcidin-25 of 178 maintenance peritoneal dialysis patients was determined by enzyme-linked immunoassay. The bilateral common carotid artery intima-media thickness （IMT） and carotid artery atheromatous plaque was measured by high resolution two-dimensional ultrasonic diagnostic apparatus. Results The serum hepcidin-25 level of the patients with carotid atherosclerosis group was higher than that without carotid atherosclerosis group and healthy controls group. The difference between the two groups was statistically significant （both P〈0.01）. Linear correlation analysis of serum hepcidin-25 levels and carotid IMT was positive（r=0.685, P=0.001）. Multiple stepwise regression analysis showed that serum hepcidin-25 and TNF-α levels were independent risk factors for carotid IMT. Conclusions The level of serum hepcidin-25 and tumor necrosis factor-α are independent risk factors of the carotid atherosclerosis in the maintenance peritoneal dialysis patients. It suggested that the level of serum hepcidin-25 and tumor necrosis factor-α can be used as a prediction of atherosclerosis risk factors.