糖尿病肾脏疾病合并贫血患者中医证型与IL-6、TNF-α、铁调素的关系研究

Relationship between TCM syndrome type and IL-6,TNF-αand hepcidin in patients with diabetic kidney dis⁃ease complicated with anemia

目的 研究糖尿病肾脏疾病(DKD)合并贫血患者中医证型与白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、铁调素关系。方法 选取DKD合并贫血患者245例,辨别中医证型,并检测患者IL-6、TNF-α、铁调素水平,分析其与中医证型的关系。结果 245例DKD合并贫血患者中,气阴两虚证78例(31.84%)、脾肾阳虚证70例(28.57%)、气血两虚证50例(20.41%)、阴阳两虚证47例(19.18%)。DKD合并贫血患者不同中医证型之间贫血程度不同,差异有统计学意义(χ~2=46.71,P<0.05)。阴阳两虚证患者血清IL-6、TNF-α、铁调素水平高于脾肾阳虚证患者(LSD-t分别=6.73、8.63、9.67,P均<0.05);脾肾阳虚证患者血IL-6、TNF-α、铁调素水平高于气血两虚证患者(LSD-t分别=5.15、7.19、6.44,P均<0.05);气血两虚证患者血清IL-6、TNF-α、铁调素水平高于气阴两虚证患者(LSD-t分别=8.41、19.11、8.68,P均<0.05)。结论 DKD合并贫血患者中医证型与IL-6、TNF-α、铁调素存在一定相关性,IL-6、TNF-α、铁调素有可能成为DKD合并贫血中医辨证的潜在生物学指标。

Objective To study the relationship between TCM syndrome type and interleukin-6(IL-6),tumor necro⁃sis factor-α(TNF-α)and hepcidin in patients with diabetic kidney disease(DKD)complicated with anemia.Methods A total of 245 patients with DKD complicated with anemia were enrolled to identify TCM syndrome types,and the levels of IL-6,TNF-αand hepcidin were detected,and the relationship between them and TCM syndrome types was analyzed.Results Among 245 patients with DKD complicated with anemia,78 cases(31.84%)had Qi Yin deficiency syndrome,70 cases(28.57%)had Spleen Kidney Yang deficiency syndrome,50 cases(20.41%)had Qi Blood deficiency syn⁃drome,and 47 cases(19.18%)had Yin Yang deficiency syndrome.The degree of anemia varies among different TCM syndrome types in patients with DKD combined with anemia,and the difference was statistically significant(χ2=46.71,P<0.05).The serum levels of IL-6,TNF-α,and hepcidin in patients with Yin Yang deficiency syndrome were higher than those in patients with Spleen Kidney Yang deficiency syndrome(LSD-t=6.73,8.63,9.67,P<0.05).The levels of IL-6,TNF-α,and hepcidin in patients with Spleen Kidney Yang deficiency syndrome were higher than those in patients with Qi and Blood deficiency syndrome(LSD-t=5.15,7.19,6.44,P<0.05).The levels of serum IL-6,TNF-α,and hepci⁃din in patients with Qi and Blood deficiency syndrome were higher than those in patients with Qi and Yin deficiency syn⁃drome(LSD-t=8.41,19.11,8.68,P<0.05).Conclusion There is a certain correlation between TCM syndrome type and IL-6,TNF-αand hepcidin in patients with DKD complicated with anemia,and IL-6,TNF-αand hepcidin may be potential biological indicators of TCM syndrome differentiation in DKD complicated with anemia.