2020 年第 11 期 第 15 卷

维持性血液透析患者血浆铁调素水平与贫血及血管钙化的关系

Relation between plasma hepcidin level and anemia and vascular calcification in maintenance hemodialysis patients

作者：万正红1田中2

英文作者：Wan Zhenghong1 Tian Zhong2

单位：1四川大学华西医院肾脏内科血透室，成都610000；2成都医学院第二附属医院·核工业四一六医院肾脏内科610000

英文单位：1Hemodialysis Room Department of Nephrology West China Hospital of Sichuan University Chengdu 610000 China; 2Department of Nephrology the Second Affiliated Hospital of Chengdu Medical College·Nuclear Industry 416 Hospital Chengdu 610000 China

关键词：维持性血液透析；贫血；血管钙化；铁调素；相关性 

英文关键词：Maintenancehemodialysis;Anemia;Vascularcalcification;Hepcidin;Correlation

• 摘要：

• 目的 探讨维持性血液透析（MHD）患者血浆铁调素水平与贫血及血管钙化的关系。方法 选取2018年5月至2019年5月于四川大学华西医院肾脏内科治疗的MHD患者61例作为观察组，另选取同期于该院门诊健康体检者62例作为对照组，比较2组受试者贫血参数及血管钙化评分的差异，分析血浆铁调素水平与贫血及血管钙化的相关性。结果 观察组患者红细胞计数、血红蛋白、平均血红蛋白浓度、转铁蛋白饱和度、血清铁、铁蛋白及不饱和铁结合力均低于对照组，而转铁蛋白、铁调素水平［（24±4）μmol/L比（14±3）μmol/L］及血管钙化评分均高于对照组，差异均有统计学意义（均P<0.05）。相关性分析结果显示观察组患者血浆铁调素水平与血浆中血红蛋白、血清铁、铁蛋白及转铁蛋白饱和度呈负相关（r=-0.375、-0.681、-0.371、-0.419，P=0.003、<0.001、0.003、0.001），而与血管钙化评分呈正相关（r=0.497，P<0.001）。多元线性回归分析显示MHD患者血清铁水平的降低是血浆铁调素水平升高的高危预测因素(P<0.001)。结论 MHD患者血浆铁调素水平与血浆中血红蛋白、血清铁、铁蛋白及血管钙化评分存在显著相关性，血清铁水平降低是血浆铁调素水平升高的高危预测因素，临床可据此加强患者管理以改善预后。

• Objective To investigate the relation between plasma hepcidin level and anemia and vascular calcification in maintenance hemodialysis(MHD) patients. Methods Totally 61 patients with MHD admitted to department of nephrology, West China Hospital of Sichuan University from May 2018 to May 2019 were selected as the observation group; 62 healthy people examined in outpatient department were selected as the control group. The differences of anemia parameters and calcification scores were compared between the two groups; the correlation between the level of plasma hepcidin, anemia and vascular calcification were analyzed. Results Red blood cell count, hemoglobin, mean hemoglobin concentration, transferrin saturation, serum iron, ferritin and unsaturated iron binding in observation group were lower than those in control group; transferrin, hepcidin level ［（24±4）μmol/L vs （14±3）μmol/L］ and vascular calcification scores in observation group were higher than those in control group(all P<0.05). The correlation analysis showed that the level of hepcidin in observation group was negatively correlated with hemoglobin, serum iron, ferritin, transferrin saturation（r=-0.375, -0.681, -0.371, -0.419; P=0.003, <0.001, 0.003, 0.001）; it was positively correlated with vascular calcification score（r=0.497， P<0.001）. Multivariate linear regression analysis showed that the decrease of serum iron level in MHD patients was a high risk predictor of the increase of plasma hepcidin level(P<0.001). Conclusions Plasma ferritin level in MHD patients is significantly correlated with plasma hemoglobin, serum ferritin, ferritin and vascular calcification score. The reduction of serum iron level is a high risk predictor of increased plasma ferritin level, which can be used to enhance clinical management of patients to improve prognosis.