血清铁调素与血液透析患者铁负荷及微炎症状态相关徐雁1邹建洲2.doc

血清铁调素与血液透析患者铁负荷及微炎症状态相关 徐雁 邹建洲 刘中华 蒋素华 徐少伟 沈波 晋玮 滕杰 丁小强* 【摘要】目的 探讨维持性血液透析（MHD）患者血清铁调素水平与铁负荷及微炎症状态的关系。方法 选取稳定的MHD治疗6个月以上患者48例，以体检健康人20例为对照组。采用酶联免疫吸附法（ELISA）测定血清铁调素和IL-6。用Spearman相关和线性回归分析铁调素与其他指标的相关性。结果 MHD患者血清铁调素（225.6[146.4-455.9]ng/ml vs 90.4[54.5-171.5]ng/ml, P0.05）和IL-6（48[35.0-97.2]pg/ml vs 43.9 [26.5-51.6] pg/ml, P0.05）皆显著高于对照组。Spearman相关分析显示血清铁调素与铁蛋白（ρ=0.892, P0.001）、转铁蛋白饱和度（ρ=0.289, P=0.049）及IL-6（ρ=0.439, P=0.002）呈正相关；与不饱和铁结合力（ρ=-0.570，P0.001）、总铁结合力（ρ=-0.552, P0.001）及转铁蛋白（ρ=-0.532, P0.001)呈负相关。线性回归分析显示铁蛋白（β=0.736，P0.001）及总铁结合力(β=-0.204，P=0.034)与血清铁调素水平独立相关。结论 MHD患者血清铁调素水平显著升高；血清铁调素水平与MHD患者铁负荷及微炎症状态相关；ELISA方法检测铁调素可以应用于临床，结合hsCRP及铁代谢指标等指导肾性贫血中铁剂的应用。 【关键词】 铁调素；血液透析；炎症；贫血；铁 Serum hepcidin in hemodialysis patients is associated with iron status and microinflammation XU Yan, ZOU Jianzhou, LIU Zhonghua, JIANG Suhua, XU Shaowei, SHEN Bo, JIN Wei, TENG Jie, DING Xiaoqiang. Department of nephrology, Zhongshan Hospital, Fudan University, Shanghai, China, 200032. 【Abstract】Objective To investigate the relationship between serum hepcidin , iron status and microinflammation in maintenance hemodialysis (MHD) patients. Methods Serum was obtained from 48 MHD patients before and after undergoing hemodialysis and 20 age-matched healthy subjects. In a cross-sectional study, serum hepcidin and IL-6 levels were measured by enzyme-linked immunosorbant assay (ELISA). Spearman correlation and linear regression were used to assess the relationship between serum hepcidin levels and other laboratory parameters in MHD patients. Results Serum hepcidin（225.6[146.4-455.9]ng/ml vs 90.4[54.5-171.5]ng/ml, P0.05） and IL-6 (48 [35.0-97.2]pg/ml vs 43.9 [26.5-51.6]pg/ml, P0.05) levels were significantly higher in MHD patients compared with controls. In all MHD patients serum hepcidin levels correlated positively with ferritin（ρ=0.892, P0.001）, transferrin saturation（ρ=0.289, P=0.049）and IL-6（ρ=0.439, P=0.002）; and negatively with unsaturated iron-binding capacity （ρ=-0.570，P0.001）, total