慢性肾脏病患者血清IL-6、Cys C、TNF-α与肌肉减少症的关系及对患者死亡风险的影响

Relationship between Serum IL-6,Cys C,and TNF-αand Sarcopenia in Patients with Chronic Kidney Disease and Its Impact on Patient Mortality Risk

目的探究慢性肾脏病(CKD)患者血清白细胞介素-6(IL-6)、胱抑素C(Cys C)、肿瘤坏死因子-α(TNF-α)与肌肉减少症的关系及对患者死亡风险的影响。方法选取2019年7月至2021年6月医院105例行维持性血液透析(MHD)的CKD患者临床资料进行回顾性研究,根据患者MHD期间有无肌肉减少症分组,分为肌肉减少组(n=27)与无肌肉减少组(n=78)。比较2组临床资料,分析血清IL-6、Cys C、TNF-α水平与SMI、HGS等人体资料的相关性,分析CKD患者血清IL-6、Cys C、TNF-α与MHD期间肌肉减少症的关系,分析CKD MHD患者生存情况,评价血清IL-6、Cys C、TNF-α水平对CKD患者死亡风险的影响。结果肌肉减少组SMI、HGS、GS均低于无肌肉减少组,血清IL-6、Cys C、TNF-α水平高于无肌肉减少组(P<0.05);肌肉减少症患者血清IL-6、Cys C、TNF-α水平与SMI、HGS、GS均呈负相关(P<0.05);血清IL-6、Cys C、TNF-α水平与CKD患者MHD期间肌肉减少症发生有关(P<0.05),随着血清IL-6、Cys C、TNF-α水平升高,CKD患者MHD期间肌肉减少症发生风险逐渐增加(P<0.05),且当血清IL-6、Cys C、TNF-α高水平时,CKD患者死亡风险分别是低水平的9.900倍、10.688倍、4.936倍。结论CKD患者MHD前血清IL-6、Cys C、TNF-α水平升高与肌肉减少症发生有关,联合检测三者水平可用于肌肉减少症患者死亡风险评估。

Objective To investigate the relationship between serum interleukin-6(IL-6),cystatin C(Cys C),tumor necrosis factor-α(TNF-α)and sarcopenia in patients with chronic kidney disease(CKD),and its impact on mortality risk.Methods A retrospective study was conducted on the clinical data of 105 CKD patients undergoing maintenance hemodialysis(MHD)in a hospital from July 2019 to June 2021.The patients were divided into two groups based on whether they had sarcopenia during MHD,namely the sarcopenia group(n=27)and the non-sarcopenia group(n=78).The clinical data of the two groups were compared,and the correlation between serum IL-6,Cys C,TNF-αlevels and human data such as SMI and HGS was analyzed.The relationship between serum IL-6,Cys C,TNF-αand sarcopenia during MHD in CKD patients was analyzed,and the survival of CKD MHD patients was analyzed.And The effects of serum levels of IL-6,CysC,and TNF-αon the risk of death in patients with CKD were evaluated.Results In the sarcopenia group,SMI,HGS,and GS were all lower than in the non-sarcopenia group,while serum levels of IL-6,Cys C,and TNF-αwere higher(P<0.05).In sarcopenia patients,serum IL-6,Cys C,and TNF-αlevels showed a negative correlation with SMI,HGS,and GS(P<0.05).Elevated levels of serum IL-6,Cys C,and TNF-αwere associated with the occurrence of sarcopenia in CKD patients during MHD(P<0.05).As serum levels of IL-6,Cys C,and TNF-αincreased,the risk of developing sarcopenia during MHD in CKD patients gradually rose(P<0.05),and when serum levels of IL-6,Cys C,and TNF-αwere high,the risk of death for CKD patients was 9.900 times,10.688 times,and 4.936 times higher,respectively,compared to low levels.Conclusion In CKD patients,higher pre-MHD serum levels of IL-6,Cys C,and TNF-αare related to the occurrence of sarcopenia.Testing all three levels together can be used to assess the mortality risk in patients with muscle loss.