CAJ | 학술논문

[目的]探讨 hepcidin 在判定慢性肾脏病(CKD)不同分期患者机体铁贮存和功能性缺铁方面的价值以及对促红细胞生成素(EPO)治疗反应的影响.[方法]检测70例 CKD 不同分期患者血清 Hepcidin 水平以及血液铁代谢指标、高敏 C 反应蛋白(hsCRP)和相关生化指标.[结果]患者血清 Hepcidin 水平随着肾小球滤过功能减退,逐渐升高,CKD 5期血透组 Hepcidin 水平最高(120.81±6.65μg/L)( P < 0.001).血透组Hepcidin 水平与血清铁蛋白和转铁蛋白饱和度呈正相关.在不考虑 CKD 分期的情况下,血清 hepcidin 水平与 hsCRP 呈正相关,与肾小球滤过率(GFR),外周红细胞计数和红细胞压积呈负相关.在血透组 A 、B 亚组中,EPO ≥9000 IU 的 A 组血清 hepcidin 水平高于 EPO <9000 IU 的 B 组( P < 0.001).[结论]慢性肾脏病时随着 GFR 的下降,血清 hepcidin 水平增加,这可能与肾脏清除 hepcidin 减少和 CKD 时存在微炎症状态有关.血清 hepcidin 升高引起功能性铁缺乏,贮存铁利用障碍和 EPO 低反应,最终使贫血难以纠正.
[목적]탐토 hepcidin 재판정만성신장병(CKD)불동분기환자궤체철저존화공능성결철방면적개치이급대촉홍세포생성소(EPO)치료반응적영향.[방법]검측70례 CKD 불동분기환자혈청 Hepcidin 수평이급혈액철대사지표、고민 C 반응단백(hsCRP)화상관생화지표.[결과]환자혈청 Hepcidin 수평수착신소구려과공능감퇴,축점승고,CKD 5기혈투조 Hepcidin 수평최고(120.81±6.65μg/L)( P < 0.001).혈투조Hepcidin 수평여혈청철단백화전철단백포화도정정상관.재불고필 CKD 분기적정황하,혈청 hepcidin 수평여 hsCRP 정정상관,여신소구려과솔(GFR),외주홍세포계수화홍세포압적정부상관.재혈투조 A 、B 아조중,EPO ≥9000 IU 적 A 조혈청 hepcidin 수평고우 EPO <9000 IU 적 B 조( P < 0.001).[결론]만성신장병시수착 GFR 적하강,혈청 hepcidin 수평증가,저가능여신장청제 hepcidin 감소화 CKD 시존재미염증상태유관.혈청 hepcidin 승고인기공능성철결핍,저존철이용장애화 EPO 저반응,최종사빈혈난이규정.
Objective] To explore the value of the detection of serum hepcidin in evaluating iron storage and deficiency in patients with different stages of chronic kidney disease (CKD) and its effect on the response to erythropoietin(EPO) treatment .[Methods] Serum hepcidin ,iron metabolic index ,high sensitive C‐reactive protein(hsCRP) and related biochemical indicators of 70 patients with different stages of CKD were detected .[Results]Serum hepcidin gradually increased with the declining of glomerular filtration rate (GFR) .Serum hepcidin in hemodialysis group at CKD5 stage was the highest(120 .81 ± 6 .65 μg/L)( P < 0 .001) .Serum hep‐cidin in hemodialysis group was correlated positively with serum ferritin and transferin saturation .In spite of the stage of CKD ,serum hepcidin was correlated positively with hsCRP and negatively with GFR ,periphery red blood cell count and hematocrit .In hemodialysis group ,serum hepcidin in subgroup A with EPO ≥ 9000IU was higher than that in subgroup B with EPO < 9000IU ( P < 0 .001) .[Conclusion] Serum hepcidin level in CKD patients increases with the declining of GFR .The increasing of serum hepcidin may be correlated with the decreased hepcidin clearance and microinflammation status in CKD patients .The rising level of serum hep‐cidin can induce functional iron deficiency ,the disorder of stored iron utilization and EPO hyporesponsiveness , subsequently result in refractoriness to anemia therapy .