【摘要】 目的研究维持性血液透析(MHD)患者血清低氧诱导通路相关指标表达水平与肾性贫血相关因素分析。方法选取2019年1月-2020年1月于吉林大学第二医院血液净化中心行规律血液透析治疗的MHD患者,根据血红蛋白(Hb)水平及是否应用促红细胞生成素(EPO)分为4组:EPO应答组、EPO低应答组、无贫血组、贫血未治疗组。采用双抗体夹心酶联免疫吸附法测定MHD患者的血清铁调素(Hepcidin)、低氧诱导因子1α(HIF-1α)、低氧诱导因子2α(HIF-2α)、脯氨酰羟化酶(PHD)的表达水平,分析其与肾性贫血的相关关系。结果 MHD患者中,肾性贫血患者的血清Hepcidin、HIF-1α、PHD表达水平较无贫血患者明显升高,HIF-2α与之相反。Spearman相关分析得出,MHD患者血清Hepcidin与血清铁蛋白、年龄及透前收缩压呈正相关,与Hb、红细胞计数、红细胞压积、BMI呈负相关;血清PHD与EPO用量、铁剂用量、BMI呈正相关;血清HIF-1α与PHD、Hepcidin、血清铁蛋白呈正相关,与HIF-2α、血肌酐、血尿酸呈负相关;血清HIF-2α与EPO用量、铁剂用量呈负相关,与红细胞压积呈正相关;Hb与血清Hepcidin、血清铁蛋白、透前收缩压、EPO用量、年龄呈负相关,与BMI呈正相关。结论 MHD患者血清低氧诱导通路相关指标水平与肾性贫血等指标相关,提示低氧诱导通路可能参与了肾性贫血的发生发展过程。更多还原

【Abstract】 Objective To study the expression level of related indexes of serum hypoxia-inducible factor pathway and the related factors of renal anemia in MHD patients.Methods From January 2019 to January 2020,MHD patients with complete data of regular hemodialysis treatment in the blood purification center of The Second Hospital of Jilin University were selected as research objects.According to the level of Hb and the application of EPO,they were divided into four groups:EPO response group、EPO low-response group、non-anemia group、anemia untreated group.The expression of serum hepcidin,serum HIF-1α,serum HIF-2αand serum PHD in MHD patients was measured by ELISA,and the relationship between renal anemia and renal anemia was analyzed.Results In MHD patients,the levels of serum hepcidin,serum HIF-1αand serum PHD in renal anemia patients were significantly higher than those in non-anemia patients.But the serum HIF-2αwas the opposite.Spearman correlation analysis showed that serum hepcidin was positively correlated with serum ferritin,age and systolic pressure before dialysis,negatively correlated with Hb,RBC count,HCT and BMI;There was a positive correlation between serum PHD and the dosage of EPO,dosage of iron and BMI;The serum HIF-1αwas positively correlated with serum PHD,serum hepcidin and serum ferritin,negatively correlated with serum HIF-2α,serum creatinine and serum uric acid;The serum HIF-2αwas negatively correlated with the dosage of EPO and dosage of iron,and positively correlated with HCT;The Hb was negatively correlated with serum hepcidin,serum ferritin,systolic pressure before dialysis,the dosage of EPO and age,and positively correlated with BMI.Conclusion The level of serum hypoxia-inducible factor pathway in MHD patients is related to renal anemia,suggesting that hypoxia-inducible factor pathway may be involved in the occurrence and development of renal anemia.更多还原