腹膜透析患者血清铁调素-25与铁代谢的相关性研究

The Study on the Correlation between Hepcidin-25 and Iron Metabolism in the Patients with Peritoneal Dialysis

目的研究持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者血清铁调素-25(Hepcidin-25)水平与铁代谢状态及残余肾功能等之间的关系。方法选择病情稳定且接受6个月以上CAPD治疗的患者70例作为CAPD组;体检中心40例健康者作为对照组。采用酶联免疫吸附双抗体夹心法(ELISA)测定血清Hepcidin-25水平,同时检测受试者血清铁、铁蛋白(Fer)、转铁蛋白(TRF)、总铁结合力(TIBC)、血生化,血常规,估算肾小球滤过率(eGFR)。Pearson法分析Hepcidin-25与其他临床指标的相关性。结果与对照组相比,CAPD组患者血红蛋白(Hb)及eGFR降低;血肌酐,尿素及全段甲状旁腺激素升高,组间比较差异均有统计学意义(P<0.001)。CAPD组的血清铁、TRF、TIBC明显降低,Fer和Hepcidin-25明显升高,差异均有统计学意义(P<0.001)。Pearson相关分析结果显示,CAPD组血清Hepcidin-25水平与Fer呈正相关(r=0.531,P<0.05);与Hb及eGFR呈负相关(r=-0.675、-0.543,P<0.05)。结论 CAPD患者血清Hepcidin-25水平升高,与机体残余肾功能、贫血状态有关。

Objective To study the correlation of Hepcidin-25 with the status of iron metabolism and the residual renal function in patients with continuous ambulatory peritoneal dialysis（CAPD）.Methods 70 stable patients who had accepted CAPD treatment for more than six months were selected and divided into the CAPD group;while the other 40 healthy subjects in the medical examination center were selected and divided into the control group.The enzyme-linked immunosorbent assay（ELISA）was adopted to measure the levels of Hepcidin-25 and the routine methods were used to measure the levels of serum iron,ferritin（Fer）,transferrin（TRF）,total iron binding capacity（TIBC）,blood biochemistry,and blood routine.Meanwhile,the glomerular filtration rate（eGFR）was estimated.Then,the Pearson correlation analysis was used to analyze the correlation of serum Hepcidin-25 with other clinic indexes.Results The levels of eGFR and hemoglobin were significantly lower in the CAPD group than in the control group（P〈0.001）,but the levels of serum creatinine,serum urea,and serum intact parathyroid hormone were significantly higher in the CAPD group（P〈0.001）.The levels of serum iron,TRF and TIBC were significantly lower in the CAPD group than in the control group,while the levels of Fer and Hepcidin-25 were significantly higher in the CAPD group（P0.05）.The results of Pearson correlation analysis revealed that serum Hepcidin-25 was positively correlated with Fer（r=0.531,P〈0.05）,but it was negatively correlated with Hb（r=-0.675,P0.05）and eGFR（r=-0.543,P〈0.05）.Conclusion The elevated levels of serum Hepcidin-25 in the CAPD patients are correlated with the status of anemia and residual renal function.