Hepcidin、IL-6、TNF-α在3种慢性病贫血中的临床意义

Clinical significance of serum hepcidin level and IL-6,TNF-αlevel in three kinds of anemia of chronic disease

目的 探讨铁调素(hepcidin)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)在不同病因慢性病贫血(ACD)中的差异和临床意义。方法 选取ACD患者90例、缺铁性贫血(IDA)患者16例、健康志愿者16例(对照组)。并根据病因将90例ACD患者分为3组:实体肿瘤贫血组、血液肿瘤贫血组、风湿免疫疾病贫血组,检测hepcidin、IL-6、TNF-α、血红蛋白(Hb)水平。结果 与对照组、IDA组比较,ACD组hepcidin、IL-6、TNF-α水平明显升高,差异有统计学意义(P<0.05);ACD组组间比较,各指标差异无统计学意义(P>0.05)。ACD组hepcidin与IL-6呈正相关(r=0.407,P<0.05),而与TNF-α无相关性(P>0.05),hepcidin、IL-6、TNF-α均与Hb无相关性(P>0.05)。结论 慢性病贫血的病因对hepcidin、IL-6、TNF-α无明显影响,hepcidin、IL-6、TNF-α在慢性病贫血的发生发展中起着重要作用。

Objective To explore the difference and clinical significance of serum hepcidin level and interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)level in anemia of chronic disease(ACD)with different causes.Methods The group of ACD consisted of 90 patients,and the group of iron deficiency anemia(IDA)consisted of 16 patients,the control group included 16 healthy people.According to the cause of anemiam,90 cases of ACD patients were divided into three groups:solid tumor anemia,hematologic malignance anemia and rheumaimmune disease anemia groups.The serum level of hepcidin,IL-6,TNF-αand hemoglobin were tested in all patients.Results The levels of hepcidin,IL-6 and TNF-αin groups of ACD were obviously higher than that in IDA andcontrol groups,,differences are statistically significant(P<0.05),but there were no significant difference in the kinds of ACD group(P>0.05).In ACD group,the level of hepcidin was positively correlated with IL-6 level(r=0.407,P<0.05),but was not correlated with TNF-α(P>0.05).There was no correlation betweenhepcidin,IL-6,TNF-αand hemoglobinin ACD group(P>0.05).Conclusion Etiological factors of chronic diseases anemia were no relationship to levels of hepcidin,IL-6 and TNF-α.Hepcidin,IL-6 and TNF-αmay play an important role in occurrence and development of ACD.