中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (01): 8-11.doi: 10.3969/j.issn.1671-4091.2014.1.003

• 临床研究 • 上一篇    下一篇

高通量血液透析对血清铁调素水平变化的影响及相关因素分析

殷培,李冀军,宋岩,王建红,陈凤锟,赵长征   

  1. 解放军总医院第一附属医院肾内科
  • 收稿日期:2013-08-05 修回日期:2013-11-25 出版日期:2014-01-12 发布日期:2014-01-12
  • 通讯作者: 李冀军 lijj9536@sina.com E-mail:doctorjia@vip.sina.com

Impact of high-flux hemodialysis on serum hepcidin and its relative factors

  • Received:2013-08-05 Revised:2013-11-25 Online:2014-01-12 Published:2014-01-12

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摘要： 目的观察维持性血液透析患者高通量透析治疗后血清铁调素(Hepcidin)水平的变化，并探讨相关影响因素。方法维持性血液透析患者40 例，高通量透析治疗12 月。分别于0 月、2 月、6 月、12月采血，检测血清Hepcidin、铁代谢相关指标、贫血指标及炎症指标超敏C 反应蛋白(hs-CRP)。采用Pearson 相关和多元回归方法分析血清铁调素与其它指标的相关性。结果高通量透析后各时间点血清Hepcidin 水平均显著高于0 月(P＜0.01)。铁蛋白、hs- CRP 与Hepcidin 水平变化趋势大致相符。Pearson 相关分析显示，Hepcidin 与血清铁、转铁蛋白铁饱和度、铁蛋白、hs-CRP 和β2微球蛋白呈正相关(r=0.164、P＜0.05，r=0.168、P＜0.05，r=0.173、P＜0.05，r=0.204、P＜0.01，r=0.692、P＜0.01)。多元回归显示，高通量透析治疗患者的转铁蛋白饱和度、hs-CRP、血红蛋白及β2微球蛋白水平与血清Hepcidin水平密切相关。结论Hepcidin 水平可以反映机体铁储备的状况，微炎症状态是影响Hepcidin 表达的关键因素。高通量透析治疗可以改善维持性血液透析患者的铁代谢状态，患者的炎症状态变化是其改变的重要影响因素。

关键词: 铁调素, 血液透析, 高通量血液透析, 铁代谢, 炎症, 贫血

Abstract: Objective To investigate the change of serum hepcidin in patients after switching from maintenance hemodialysis (MHD) to high- flux hemodialysis (HFD), and to analyse its related factors. Methods Forty MHD patients were enrolled. They were then changed to HFD for 12 months. Serum hepcidin, blood indices of iron metabolism, anemia and inflammation (high sensitivity C- reactive protein, hs- CRP) were assayed at 0 month, 2 months, 6 months and 12 months after the switching. Pearson correlation and multiple stepwise regression methods were used to analyze the relationship between serum hepcidin and these indices. Results Serum hepcidin levels after the switching for 2, 6 and 12 months were significantly higher than the level at 0 month (P＜0.01). Changes of ferritin and hs-CRP were consistent with the change of serum hepcidin. Pearson correlation analysis showed that serum hepcidin was positively correlated with serum iron (r= 0.164, P＜0.05), transferrin saturation (r=0.168, P＜0.05), ferritin (r=0.173, P＜0.05), hs-CRP (r=0.204, P＜ 0.01) and β2- microglobulin (r=0.692, P＜0.01). Multiple stepwise regression showed that transferrin saturation, hs-CRP, hemoglobin and β2-microglobulin levels were closely related to serum hepcidin level in HFD patients. Conclusions Serum hepcidin can reflect the iron storage in the body. Microinflammatory state is a key factor affecting hepcidin expression in hemodialysis patients. HFD may improve the iron metabolism status in MHD patients. Microinflammatory status is the important factor that influences the improvement processes.

Key words: Hepcidin, Hemodialysis, High-flux hemodialysis, Iron metabolism, Inflammation, Anemia