摘要
目的 研究持续不卧床腹膜透析（CAPD）患者血清铁调素水平与残余肾功能、微炎性反应状态的关系.方法 选择接受CAPD治疗3个月以上,病情稳定的患者34例为观察组（CAPD组）;非透析CKD5期患者20例为对照组.观察组按超敏C反应蛋白（hs-CRP）水平分为2个亚组：hs-CRP升高组（hs-CRP＞ 3.00 mg/L,14例）;hs-CRP正常组（hs-CRP≤3.00 mg/L,20例）.观察组无残余肾功能（24 h尿量≤100 ml）患者14例.采用酶联免疫吸附双抗体夹心（ELISA）法测定血清铁调素,同时检测患者血铁蛋白（Fer）、hs-CRP、血生化、血常规,估算肾小球滤过率（eGFR）.采用Pearson相关和多元逐步线性回归法分析铁调素与其他临床指标的相关关系.结果 与对照组相比,CAPD组患者血铁调素水平升高,eGFR降低,组间比较差异有统计学意义（均P＜ 0.05）.CAPD组无残余肾功能患者血铁调素水平较有残余肾功能组升高更明显（P＜0.05）;hs-CRP升高组血铁调素水平较hs-CRP正常组明显升高（P＜0.05）.Pearson相关分析结果显示,CAPD组血铁调素与hs-CRP、Fer呈正相关（r分别为0.501、0.847,均P＜0.01）;与血红蛋白、转铁蛋白（TRF）、总铁结合力（TIBC）等呈负相关（r分别为-0.919、-0.751、-0.532,均P＜0.05）.多元逐步线性回归分析结果显示：CAPD患者Fer及hs-CRP与铁调素水平呈相关关系.结论 CAPD患者血铁调素水平较非透析CKD5期患者显著升高,无残余肾功能患者和微炎性反应状态下,CAPD患者血清铁调素水平的升高更明显.
Objective To study the correlation of serum hepcidin with residual renal function and micro-inflammation state in continuous ambulatory peritoneal dialysis （CAPD） patients.Methods Thirty-four stable CADP patients were involved in this study as observers （CAPD group）,who had accepted CAPD treatment more than three months; twenty non-dialysis patients with stage 5 of chronic kidney disease were selected as control group.According to the level of high sensitivity Creactive protein （hs-CRP）,CAPD patients were divided into two subgroups.There were 14 patients in the hsCRP elevated group （hs-CRP ＞ 3.00 mg/L） and 20 patients in the hs-CRP normal group.In addition,there had been 14 patients with residual renal function in CAPD group.Serum hepcidin was measured by ELISA.Serum Ferritin （FER）,hs-CRP,routine blood and biochemistry were measured by routine methods.Calculated estimated glomerular filtration rate （eGFR）.Pearson correlation and linear regression were used to assess the correlation of serum hepcidin with other laboratory parameters in CAPD patients.Results （1） Serum hepcidin was significantly higher in CAPD patients than control group,but eGFR was significantly lower （P ＜ 0.01）.（2） Serum hepcidin levels of no residual renal function patients increased more significantly in CAPD group （P ＜ 0.05）.（3） Serum hepcidin levels were higher in hs-CRP elevated group than hs-CRP normal group （P ＜ 0.05）.（4） Pearson correlation analyses revealed that serum hepcidin was positively correlated with hs-CRP （r=0.501） and FER （r=0.847,all P ＜ 0.01）,and was negatively correlated with Hb （r=-0.919）,TRF （r=-0.751）,TIBC （r=-0.532,all P ＜ 0.05）.（5） Multiple linear regression analysis showed that ferritin and hs-CRP were closely associated with serum hepcidin level in CAPD.Conclusions Serum hepcidin level markedly elevate in CAPD patients,especially in the patients with no residual renal function and micro inflammatory state increased more significantly.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2014年第10期739-743,共5页
Chinese Journal of Nephrology
关键词
腹膜透析
微炎症
铁调素
残余肾功能
Peritoneal dialysis
Micro inflammatory state
Hepcidin
Residual renal function
