活性维生素D3对维持性血透患者hepcindin影响的研究分析.docVIP

精品论文 参考文献 活性维生素D3对维持性血透患者hepcindin影响的研究分析 湖南省娄底市中心医院肾内科 湖南娄底 417000 摘要：目的：探讨活性维生素D3对维持性血透（MHD）患者铁调素（hepcindin）表达的影响以及对不宁腿综合征、贫血的影响。方法：将38例维持性血透并发不宁腿综合征的患者随机分成治疗组和对照组，治疗组在对照组治疗的基础上加用合理的活性维生素D3进行治疗。结果：治疗组血清iPTH、hsCRP、HBG、IL－6、hepcidin、铁治疗前后比较P＜0.05；治疗后治疗组与对照组比较P＜0.05。血清hepcidin 的表达与血清铁、血红蛋白、hsCRP、IL－6 的表达相关，并且与血清铁、血红蛋白呈负相关，与血清hsCRP、IL－6 的表达呈正相关，且不宁腿综合征的临床症状明显减轻甚至消失。结论：活性维生素D3可抑制维持性血透患者hepcindin的表达，改善维持性血透患者的微炎症环境，改善贫血和不宁腿综合征的症状，为临床难治性肾性贫血提供新的治疗思路，为寻找新的治疗靶点及药物提供基础，改善了维持性血透患者的生存质量和生活质量，减少其住院率、输血率和死亡率，减少血液资源的浪费，减轻患者家庭经济负担，具有良好的社会效益及经济效益。 关键词：活性维生素D3；维持性血透；铁调素；血清铁；血红蛋白 Abstract：Objective：It is to explore the effects of active vitamin D3 on levels of hepcindin in patients with maintenance hemodialysis（MHD），on restless legs syndrome and anemia.Methods：38 MHD patients with restless legs syndrome were randomly divided into two groups：treatment group and control group.Treatment group were treated with active vitamin D3 in addition to the routine medicine treatment to the control group.Results：There were significant differences in levels of serum iPTH，hsCRP，HGB，IL－6，hepcidin and serum iron after treatment compared with those before treatment in treatment group（Plt;0.05）.After treatment，there were also apparent differences in levels of serum iPTH，hsCRP，HGB，IL－6，hepcidin and serum iron between treatment group and control group（Plt;0.05）.The level of serum hepcidin is correlated with the level of serum iron，HGB，hsCRP，IL－6.It is revealed that the level of serum hepcidin is positively correlated with the level of hsCRP and IL－6 while negatively with that of serum iron and HGB.It is also founded that the symptoms of restless legs syndrome were obviously relieved or even disappeared.Conclusions：Active vitamin D3 can decrease the level of hepcindin and thus improve the micro-inflammation in MHD patients.It can also improve the symptom of anemia and restless legs syndrome，which provides a new idea for the treatment of refractory renal anemia and lays a good foundation for seeking new