CAJ | 학술논문

目的：探讨尿毒症患者由常规血液透析转换为高通量血液透析治疗后血清中可溶性转铁蛋白受体（ sTfR）水平的变化及相关影响因素。方法选择维持性血液透析患者40例，转换为高通量血液透析治疗12个月。分别于高通量血液透析治疗前（ T0）及治疗后2个月（ T1）、6个月（ T2）、12个月（ T3）测定血清sTfR水平、贫血相关指标、铁代谢指标及炎症指标。采用Pearson相关分析和多元逐步回归分析血清sTfR水平与其他指标的相关性。同时观察促红细胞生成素、铁剂治疗用量的变化趋势。结果与T0比较，T1、T2、T3血清sTfR水平明显降低（ P均＜0．01）。 Pearson相关分析显示，T1、T2、T3时血清sTfR水平与Ret％、SF均呈正相关（ r分别为0．154、0．152， P均＜0．05），与Hb、HCT、β2-MG、TBC均呈负相关（r分别为－0．251、－0．299、－0．384、－0．166，P＜0．05或＜0．01）。多元逐步回归分析显示，高通量血液透析治疗患者的HCT、TSAT、β2-MG与血清sTfR水平密切相关（ P均＜0．01）。本组促红细胞生成素和铁剂治疗用量随高通量血液透析时间的延长而逐渐减少（P＜0．05）。结论高通量血液透析可以改善常规血液透析患者的贫血情况，血清sTfR水平可以反映血液透析患者铁负荷状况及红细胞生成刺激的效应。
목적：탐토뇨독증환자유상규혈액투석전환위고통량혈액투석치료후혈청중가용성전철단백수체（ sTfR）수평적변화급상관영향인소。방법선택유지성혈액투석환자40례，전환위고통량혈액투석치료12개월。분별우고통량혈액투석치료전（ T0）급치료후2개월（ T1）、6개월（ T2）、12개월（ T3）측정혈청sTfR수평、빈혈상관지표、철대사지표급염증지표。채용Pearson상관분석화다원축보회귀분석혈청sTfR수평여기타지표적상관성。동시관찰촉홍세포생성소、철제치료용량적변화추세。결과여T0비교，T1、T2、T3혈청sTfR수평명현강저（ P균＜0．01）。 Pearson상관분석현시，T1、T2、T3시혈청sTfR수평여Ret％、SF균정정상관（ r분별위0．154、0．152， P균＜0．05），여Hb、HCT、β2-MG、TBC균정부상관（r분별위－0．251、－0．299、－0．384、－0．166，P＜0．05혹＜0．01）。다원축보회귀분석현시，고통량혈액투석치료환자적HCT、TSAT、β2-MG여혈청sTfR수평밀절상관（ P균＜0．01）。본조촉홍세포생성소화철제치료용량수고통량혈액투석시간적연장이축점감소（P＜0．05）。결론고통량혈액투석가이개선상규혈액투석환자적빈혈정황，혈청sTfR수평가이반영혈액투석환자철부하상황급홍세포생성자격적효응。
Objective To investigate the changes in levels of serum soluble transferrin receptor ( sTfR) after switc-hing from maintenance hemodialysis to high-flux hemodialysis ( HFD) in patients with uremia, and to analyze its related factors.Methods Forty patients undergoing low-flux maintenance hemodialysis were treated by high-flux maintenance he-modialysis for 12 months.The levels of sTfR, iron metabolism indices, anemia index and inflammatory index were meas-ured before HFD treatment ( T0 ) and after HFD treatment for 2 months ( T1 ) , 6 months ( T2 ) and 12 months ( T3 ) .Pear-son correlation and multiple regression method were used to analyze the relationship between serum sTfR and other indexes. At the same time, we observed the changing trend of erythropoietin and the amount of iron therapy.Results Serum sTfR level was significantly decreased at T1 , T2 and T3 as compared with that at T0 , and significant difference was found ( all P<0.01).Pearson correlation analysis showed that sTfR was positively correlated with Ret%, SF (r=0.154, 0.152;all P<0.05) and was negatively correlated with Hb, HCT, β2-MG and TBC ( r =-0.251, -0.299, -0.384 and-0.166;P<0.01 or P<0.05).Multiple regression showed that HCT, TSAT andβ2-MG levels were closed related with serum sTfR level in HFD patients (all P<0.01).The erythropoietin and iron dosage in this group reduced with prolonged HFD treatment.Conclusions HFD can effectively improve renal anemia in patients with maintenance hemodialysis.The detection of sTfR level reflects the effects of iron reserves and erythropoietic stimulation on patients.