维持性血液透析患者缺铁状态与微炎症的相关性研究

Relationship between iron-deficiency status and micro-inflammation in maintenance hemodialysis patients

目的探讨维持性血液透析(MHD)患者肾性贫血缺铁状态与微炎症之间的相关性,为临床治疗提供参考依据。方法选取医院2013年1-6月MHD患者54例,将其分为功能性铁缺乏组29例和绝对性铁缺乏组25例,另选30名健康志愿者为对照组,对比分析各组间铁代谢指标、炎性因子的差异;皮尔森相关和逐步回归分析铁代谢指标和炎性指标的相关性。结果功能性铁缺乏组和绝对性铁缺乏组在高敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、铁调素、血清白蛋白(ALB)、二氧化碳结合力(CO2CP)方面比较差异有统计学意义(P<0.05);Pearson相关性分析发现铁蛋白(SF)与铁调素、hs-CRP、IL-6呈正相关(r分别为0.64、0.35、0.46,P<0.05),与血红蛋白(Hb)、红细胞压积(HCT)、红细胞铁含量、转铁蛋白(TRF)、ALB成负相关(r值分别为-0.48、-0.48、-0.28、-0.43、-0.47,P<0.05);铁调素与铁蛋白、IL-6呈正相关(r值分别为0.68、0.34,P<0.05);逐步回归分析显示,MHD患者铁蛋白的密切相关因素为Hb、Hs-CRP、铁调素。结论功能性铁缺乏性贫血与微炎症有关;铁调素可反映MHD患者缺铁和炎症状态。

OBJECTIVE To investigate the relationship between renal anemia iron-deficiency status and the micro-inflammation in maintenance hemodialysis patients so as to provide guidance for clinical treatment.METHODS A total of 54 patients who underwent the maintenance hemodialysis from Jan 2013 to Jun 2013 were enrolled in the study and divided into the functional iron deficiency group with 29 cases and the absolute iron deficiency group with25 cases,meanwhile,30 healthy volunteers were chosen as the control group.The iron metabolism indexes and inflammatory factors were observed and compared among the three groups,and the Pearson correlation analysis and stepwise regression analysis was performed for the correlation between the iron metabolism indexes and the inflammatory factors.RESULTS There was significant difference in the high-sensitivity C-reactive protein（hs-CRP）,interleukin-6（IL-6）,hepcidin,serum albumin（ALB）,or carbon dioxide combining power（CO2CP）between the functional iron deficiency group and the absolute iron deficiency group（P〈0.05）.The Pearson correlation analysis showed that the ferritin was positively correlated with hepcidin,hs-CRP,and IL-6（r=0.64,0.35,and 0.46,P〈0.05）;the ferritin was negatively correlated with hemoblobin（Hb）,hematocrit（HCT）,erythrocyte iron content,transferrin（TRF）,and ALB（r=-0.48,-0.48,-0.28,-0.43,and-0.47,P〈0.05）;the hepcidin was positively correlated with ferritin and IL-6（r=0.68,0.34,P〈0.05）.The stepwise regression analysis indicated that the ferritin of the maintenance hemodialysis patients was closely associated with Hb,hs-CRP,and hepcidin.CONCLUSIONThe functional iron-deficiency anemia is associated with micro-inflammation;the hepcidin can reflect the status of iron-deficiency and inflammation of the maintenance hemodialysis patients.