血清β2微球蛋白浓度与维持性血液透析患者肾性贫血的相关性研究

Correlation between serumβ2-microglobulin level and renal anemia in patients on maintenance hemodialysis

目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者肾性贫血和血β2微球蛋白(β2-microglobulin,β2-MG)水平的相关性,为临床诊断和治疗肾性贫血提供新的观点和依据。方法选取2021年12月至2023年12月在武汉大学人民医院确诊为终末期肾病、病情稳定的MHD患者为研究对象,根据其血红蛋白水平分为贫血组和对照组,收集患者相关临床资料和实验室检查资料。使用SPSS 22.0软件包行数据的统计学分析处理。结果与对照组相比,贫血组血清β2-MG显著升高,患者血红蛋白与白细胞、总蛋白、白蛋白呈正相关(P<0.05),与超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)及β2-MG呈负相关(P<0.05);多因素Logistic回归显示低血白蛋白、高β2-MG水平是MHD患者发生贫血的独立危险因素。结论MHD患者血清β2-MG水平升高与血红蛋白降低相关,低血白蛋白、高血清β2-MG是患者肾性贫血的危险因素。因此在治疗MHD患者肾性贫血时,需要尤其注意患者营养状态和β2-MG等大分子炎性毒素的清除,必要时先纠正营养不良和使用β2-MG吸附柱可能对纠正肾性贫血更为有利,从而进一步减少MHD患者心血管并发症的发生,改善预后。

Objective To investigate the correlation between renal anemia and serumβ2-microglobulin(β2-MG)levels in maintenance hemodialysis(MHD)patients,and to provide a new viewpoint and basis for the clinical diagnosis and treatment of renal anemia.Methods MHD patients diagnosed with end-stage renal disease and in stable condition at the Renmin Hospital of Wuhan University from December 2021 to December 2023 were selected for the study,and were divided into the anemia group and the control group according to their hemoglobin levels,and the relevant clinical data and laboratory examination data of the patients were collected.The data were analyzed statistically via SPSS 22.0 software.Results Compared with the control group,serumβ2-MG was significantly higher in the anemia group,and the patients hemoglobin was positively correlated with leukocytes,total protein,and albumin(P<0.05),and negatively correlated with high sensitivity C-reactive protein(hs-CRP)andβ2-MG(P<0.05);multifactorial Logistic regression showed that low blood albumin and high level ofβ2-MG were the independent risk factors for the development of anemia in MHD patients.Conclusions Elevated serumβ2-MG levels in MHD patients were associated with decreased hemoglobin,and low blood albumin and high serumβ2-MG were risk factors for renal anemia in patients.Therefore,when treating renal anemia in MHD patients,special attention needs to be paid to the patients nutritional status and the clearance of large molecule inflammatory toxins such asβ2-MG;correcting malnutrition and viaβ2-MG adsorbent columns first,if necessary,may be more favorable for correcting renal anemia,thus further reducing the incidence of cardiovascular complications and improving the prognosis of MHD patients.