活性维生素d3对维持性血透患者hepcindin影响的研究分析

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1、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委底市中心医院肾内科湖南委底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一6、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

2、—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一6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，其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：Object

3、ive：ItistoexploretheeffectsofactivevitaminD3onlevelsofhepcindininpatientswithmaintenancehemodialysis(MHD)，onrestlesslegssyndromeandanemia.Methods：38MHDpatientswithrestlesslegssyndromewererandomlydividedintotwogroups：treatmentgroupandcontrolgroup.Treatmentgroupweretreatedwithactivevi

4、taminD3inadditiontotheroutinemedicinetreatmenttothecontrolgroup.Results：ThereweresignificantdifferencesinlevelsofserumiPTH,hsCRP，HGB，IL—6,hepcidinandserumironaftertreatmentcomparedwiththosebeforetreatmentintreatmentgroup(P<0.05).Aftertreatment,therewerealsoapparentdifferencesinle

5、velsofserumiPTH,hsCRP，HGB,IL—6,hepcidinandserumironbetweentreatmentgroupandcontrolgroup(P<0.05).Thelevelofserumhepcidiniscorrelatedwiththelevelofserumiron,HGB,hsCRP,IL—6.ItisrevealedthatthelevelofserumhepcidinispositivelycorrelatedwiththelevelofhsCRPandIL—6whilenegativelywiththat

6、ofserumironandHGB.ltisalsofoundedthatthesymptomsofrestlesslegssyndromewereobviouslyrelievedorevendisappeared.Conclusions：ActivevitaminD3candecreasethelevelofhepcindinandthusimprovethemicro-inflammationinMHDpatients.ltcanalsoimprovethesymptomofanemiaandrestlesslegssyndrome,whichprovi

7、desanewideaforthetreatmentofrefractoryrenalanemiaandlaysagoodfoundationforseekingnewtherapeutictargetsanddrugsforthetreatmentofMHDpatients.Therefore，itcanprolongsurvivalandimprovequalityoflifeofMHDpatientsbydecreasingrateofhospitalization，bloodtransfusionanddeath.Besides,itcanalsore

8、ducethewasteofblood