血液透析患者血清铁调素与颈动脉粥样硬化的关系

Relationship Between Hepcidin and Carotid Atherosclerosis in Main-tenance Hemodialysis Patients

目的:探讨维持性血液透析(MHD)患者血清铁调素(hepcidin)水平的变化及与颈动脉粥样硬化的相关性。方法:选择维持性血液透析患者93例和健康对照组40例为研究对象,采用ELISA法测定hepcidin、IL-6及TNF-α水平,高分辨二维超声对双侧颈总动脉内膜中膜厚度(IMT)及颈动脉粥样斑块进行测量,分析hepcidin水平与颈动脉病变及炎症因子之间的关系。结果:MHD组患者血清hepcidin水平(139.04±77.91)μg/L显著高于健康对照组(51.13±22.01)μg/L;MHD组CRP、IL-6、TNF-α水平均显著高于健康对照组(P<0.05或P<0.01)。MHD组IMT值为(1.15±0.21)mm、斑块形成率(59.2%)、颈动脉硬化的患病率(77.6%)均显著高于健康对照组的(0.78±0.28)mm和2.5%与10%(均P<0.05)。直线相关分析显示MHD组血清hepcidin水平与CRP、IL-6、TNF-α、IMT及斑块形成、颈动脉硬化率的患病率均呈正相关;与SBP、DBP、年龄亦呈正相关(P<0.05或P<0.01)。多元逐步回归分析显示,hepcidin、CRP、SBP和年龄是MHD颈动脉病变的独立危险因素。结论:MHD患者血清hepcidin水平显著升高,其可能通过促进CRP、IL-6等炎症因子的产生,参与MHD患者动脉粥样硬化的形成。

To determine the serum level of hepcidin in patients of maintenance hemodialysis （ MHD ） and to explore the relationship between hepcidin level and carotid atheroselerosis. Methods： A total of 93 maintenance hemodialysis patients and 40 healthy subjects were enrolled in this study, the serum level of hepcidin, IL - 6, and TNF - a was determined by ELISA. the carotid intima - media thickness （ IMT ） and carotid artery atheromatous plaque were measured by high resolution B - mode ultra- sounograpgy, the relationship between hepcidin level and carotid artery disease was analyzed. Results：The serum hepcidin level was signifificantly increased in MHD patients conpared with healthy subject. Accompanied with elvated serum levels of CRP ,IL- 6 ,TNF - or. The level of plaque were measured by high resolution two - dimen healthy subjects（P 〈0.01 ）. IMT of MHD group was （ 1.15 -＋ O. 21 ） mm, plaque formation rate （ 59.2% ） and carotid artery sclerosis （ 77.6% ） were significantly higher than those of healthy subjects （ O. 78 ：l：0.28 ） mm and 2.5% and 10% （P 〈0.05 ）. Linear correlation analysis showed that the serum hepcidin level in MHD group was positively correlated with the prevalence of CRP, IL- 6, TNF -c t, IMT and plaque formation and carotid atherosclero- sis. There was positive correlation with SBP, DBP, and age （ P 〈 0. 05 or P 〈 0.01 ）. Multivariate stepwise regression analysis showed that hepcidin, CRP, SBP and age were independent risk factors of carotid artery disease. Conclusion： Serum hepcidin level in MHD patients is significantly increased, serum hepeidin level is independent of carotid artery disease, and can be used as a risk factor for atherosclerosis.