维持性血液透析患者血清铁调素25的影响因素及其与血红蛋白的关系

Influencing factor of hepcidin-25 and its relationship with hemoglobin in patients undergoing maintenance hemodialysis

目的探讨维持性血液透析(MHD)患者血清铁调素25的影响因素及其与Hb的关系。方法检测52例MHD患者的血清铁调素25、Hb、转铁蛋白饱和度、铁蛋白和CRP等指标,分析铁调素25与其他指标的关系以及铁调素25的影响因素。根据血清铁蛋白和转铁蛋白饱和度水平,将患者分为铁充足组(转铁蛋白饱和度>20%,铁蛋白>100 ng/ml,18例)、铁缺乏组(转铁蛋白饱和度≤20%,12例)和其他组(转铁蛋白饱和度>20%,铁蛋白≤100 ng/ml,22例),分析血清铁调素25与Hb的关系。结果 52例患者血清铁调素25 (30.22±14.39) ng/ml,Hb(119.65±16.95) g/L,转铁蛋白饱和度(26.90±6.86)%,铁蛋白(114.24±100.64) ng/ml,CRP 3.12(3.12,8.21) mg/L,叶酸16.20(5.41,20.00) ng/ml。血清铁调素25与铁蛋白、CRP、叶酸呈正相关(r=0.917、0.524、0.294,P<0.05)。铁蛋白和CRP是铁调素25的独立影响因素(P<0.01)。铁充足组患者血清铁调素25和Hb水平高于铁缺乏组(P<0.01),铁充足组和铁缺乏组患者血清铁调素25水平高于其他组(P<0.05)。铁充足组铁调素25与Hb呈负相关(r=-0.465,P<0.05),铁缺乏组铁调素25与Hb不存在相关关系(P>0.05)。结论铁蛋白和CRP能够影响MHD患者血清铁调素25水平,铁充足时铁调素25与Hb呈负相关。

Objective To investigate the influencing factor of hepcidin-25 and its relationship with Hb in the patients undergoing maintenance hemodialysis(MHD).Methods Serum levels of hepcidin-25,Hb,transferrin saturation,ferritin and CRP were detected in 52 patients undergoing MHD.The relationship of hepcidin-25 and other indicators was analyzed.The influencing factor of hepcidin-25 was analyzed.According to the levels of transferrin saturation and ferritin,the patients were divided into groups of A(with transferrin saturation>20%,ferritin>100 ng/ml,18 cases),B(with transferrin saturation≤20%,12 cases) and C(with transferrin saturation >20%,ferritin≤100 ng/ml,22 cases).The relationship of hepcidin-25 and Hb was analyzed.Results In 52 patients undergoing MHD,serum level of hepcidin-25 was(30.22±14.39) ng/ml,Hb was(119.65±16.95) g/L,transferrin saturation was(26.90±6.86)%,ferritin was(114.24±100.64) ng/ml,CRP was 3.12(3.12,8.21) mg/L and folic acid was 16.20(5.41,20.00) ng/ml.Serum level of hepcidin-25 was positively correlated to that of ferritin,CRP and folic acid(r=0.917,0.524 and 0.294,P<0.05).Ferritin and CRP were independent influencing factors of hepcidin-25(P<0.01).Serum levels of hepcidin-25 and Hb were higher in group A than those in group B(P<0.01).Serum level of hepcidin-25 was higher in groups of A and B than that in group C(P<0.05).Hepcidin-25 was negatively correlated to Hb in group A(r=-0.465,P<0.05).Hepcidin-25 was not obviously correlated to Hb in group B(P>0.05).Conclusion Ferritin and CRP can affect the level of hepcidin-25 and hepcidin-25 is negatively correlated to Hb when iron is sufficient in the patients undergoing MHD.