维持性血液透析患者铁调素与临床相关指标及与氧化应激的关系研究

Study on the Relationship between Hepcidin and Clinical Related Indexes and Oxidative Stress in Patients with Maintenance Hemodialysis

目的研究维持性血液透析患者铁调素与临床相关指标及与氧化应激的关系。方法选取我院维持性血液透析患者40例为维持性透析组,同期健康体检者20例为对照组。检查血红蛋白、白蛋白、尿素、肌酐、血清铁、血钙、血磷、铁蛋白、C反应蛋白、甲状旁腺激素、铁调素及氧化应激指标如:MDA(丙二醛)、AOPP(超氧化蛋白产物)、SOD(过氧化氢酶),并进行相关性分析。结果维持性血液透析患者各组血红蛋白、白蛋白、血清铁、血钙、铁蛋白、SOD均较对照组低(P<0.05)。维持性血液透析组患者血尿素、肌酐、C反应蛋白、血磷、甲状旁腺激素、铁调素、MDA、AOPP均较对照组高(P<0.05)。铁调素水平与血红蛋白水平、血钙、血清铁水平呈负相关(P<0.05),而与血尿素、血肌酐、铁蛋白、血磷、甲状旁腺水平及C反应蛋白水平呈正相关(P<0.05)。与血白蛋白水平无关联性(P>0.05)。血红蛋白水平与MDA、AOPP水平呈负相关(P<0.05),与SOD呈正相关(P<0.05)。铁调素与MDA、AOPP水平呈正相关(P<0.05),与SOD呈负相关(P<0.05)。结论维持性血液透析患者铁调素表达明显增加,并且铁调素的表达增加与血红蛋白水平、血钙、血清铁水平呈负相关,而与血尿素、血肌酐、铁蛋白、血磷、甲状旁腺水平及C反应蛋白水平呈正相关。维持性血液透析患者氧化应激可能通过促进铁调素的表达增加从而参与了维持性血液透析患者贫血的发生。

Objective To study the relationship between hepcidin and clinical indexes and oxidative stress in patients with maintenance hemodialysis.Methods 40 patients with maintenance hemodialysis were selected as maintenance dialysis group and at the same time 20 healthy persons as control group.Hemoglobin,albumin,urea,creatinine,serum iron,serum calcium,serum phosphorus,ferritin,C-reactive protein,parathyroid hormone,hepcidin and oxidative stress indexes such as（ MDA） malondialdehyde、AOPP（ superoxide protein product） and SOD（ catalase） were examined,and the correlation analysis was carried out.Results The levels of hemoglobin,albumin,serum iron,blood calcium,ferritin and SOD in patients with maintenance hemodialysis were lower than those in the control group（ P〈0. 05）.The levels of blood urea,creatinine,C-reactive protein,serum phosphorus,parathyroid hormone,hepcidin and MDA,AOPP in maintenance hemodialysis group were significantly higher than those in the control group（ P〈0. 05）.Levels of hepcidin were negatively correlated with levels of hemoglobin,serum calcium and serum iron（ P〈0. 05）,but positively correlated with levels of blood urea,serum creatinine,ferritin and serum phosphorus,parathyroid gland and C-reactive protein（ P〈0. 05）,no correlation with serum albumin level（ P〈0. 05）. Hemoglobin level was negatinely correlated with MDA and AOPP（ P〈0. 05）,while Positively correlated with SOD（ P〈0. 05）. hepcidin was positively correlated with MDA and AOPP（ P〈0. 05）,but negatively correlated with SOD（ P〈0. 05）. Conclusion The expression of hepcidin was significantly increased in patients with maintenance hemodialysis,and the increased expression of hepcidin was negatively correlated with the levels of hemoglobin,serum calcium and serum iron,but positively correlated with blood urea,serum creatinine,ferritin,serum phosphorus,parathyroid gland level and C-reactive protein level.Oxidative stress may be involved in anemia in patients with maintenance hemodialysis by promoting the expression of hepcidin.