河北医科大学学报 ›› 2024, Vol. 44 ›› Issue (5): 590-594.doi: 10.3969/j.issn.1007-3205.2024.05.017

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维持性血液透析患者hs-CRP、MCP-1、IL-6表达状况及其对血管通路感染的预测效能

  

  1. 中国人民解放军联勤保障部队第九一○医院肾脏风湿科，福建 泉州 362000

  • 出版日期:2024-05-25 发布日期:2024-05-22
  • 作者简介:吴福杉（1983-），男，福建泉州人，中国人民解放军联勤保障部队第九一○医院主治医师，医学学士，从事肾脏疾病诊治研究。
  • 基金资助:
    泉州市科技计划项目（2020C009R）

Expression of hs-CRP, MCP-1 and IL-6 in patients undergoing maintenance hemodialysis and their predictive efficacy for vascular access infection

  1. Department of Nephrology and Rheumatology, the 910th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army, Fujian Province, Quanzhou 362000, China

  • Online:2024-05-25 Published:2024-05-22

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摘要： 目的 探究维持性血液透析（maintenance hemodialysis，MHD）患者外周血高敏C-反应蛋白（highly sensitive C-reactive protein，hs-CRP）、单核细胞趋化因子（monocyte chemotactic factor，MCP-1）和白细胞介素6（interleukin-6，IL-6）的表达水平及各临床因素对感染的预测效能。
方法 选取我院收治的MHD患者100例，按照在院治疗期间是否发生血管通路感染进行分组，感染组（n=30）和未感染组（n=70）。通过酶联免疫吸附法检测患者外周血hs-CRP、MCP-1和IL-6的表达水平，统计分析临床一般资料，通过多因素Logistics回归分析方法确认临床感染的风险因素，通过受试者工作曲线分析hs-CRP、MCP-1、IL-6对感染的预测效能。
结果 与未感染组相比，感染组血清hs-CRP、MCP-1和IL-6 表达水平显著升高（P＜0.05）；多因素Logistics回归分析结果表明年龄>60岁、透析时间>1年、hs-CRP、MCP-1、IL-6、合并糖尿病、血清白蛋白下降是患者发生感染的危险因素，ROC分析表明血清hs-CRP、MCP-1、IL-6 的ROC曲线下面积（the area under the ROC curve,AUC）分别为0.815、0.770和0.806，敏感度分别为68.10%、72.80%、82.00%，特异度分别为79.60%、72.70%、74.09%，而三者联合的AUC为0.935，敏感度和特异度分别为83.80%和92.91%，预测性能显著升高（Z=2.373）。
结论 MHD患者血清中hs-CRP、MCP-1、IL-6高表达，并且是患者血管通路感染的风险因素，联合使用血清hs-CRP、MCP-1和IL-6 对MHD患者发生感染具有显著的预测价值。


关键词: 血液透析, 感染, 风险因子

Abstract: Objective To explore the expression levels of high sensitive C-reactive protein (hs CRP), monocyte chemotactic protein 1 (MCP-1) and interleukin-6 (IL-6) in the peripheral blood of patients undergoing maintenance hemodialysis (MHD) and the predictive efficacy of various clinical factors for infection. 
Methods A total of 100 patients undergoing MHD admitted to our hospital were selected and divided into infection group (n=30) and non-infection group (n=70) according to occurrence of vascular access infection during hospitalization. The expression levels of hs-CRP, MCP-1 and IL-6 in peripheral blood of the patients were detected by enzyme-linked immunosorbent assay (ELISA), and the general clinical data were statistically analyzed. The risk factors of clinical infection were confirmed by multivariate Logistic regression analysis, and the predictive efficacy of hs-CRP, MCP-1 and IL-6 for infection was analyzed by receiver operating characteristic (ROC) curve. 
Results Compared with the non-infection group, the expression levels of serum hs-CRP, MCP-1 and IL-6 in the infection group were significantly higher (P＜0.05). Multivariate logistic regression analysis showed that age＞60 years, duration of dialysis >1 year, hs-CRP, MCP-1, IL-6, combined diabetes and decreased serum albumin were risk factors for infection. ROC analysis showed that the area under the ROC curve (AUC) of serum hs-CRP, MCP-1, and IL-6 was 0.815, 0.770, and 0.806, respectively, the sensitivity was 68.10%, 72.80%, 82.00%, respectively, and the specificity was 79.60%, 72.70%, and 74.09%, respectively. The AUC of the combination of the three was 0.935, and the sensitivity and specificity were 83.80% and 92.91%, respectively, and the predictive performance was significantly improved (Z=2.373). 
Conclusion The high expressions of serum hs-CRP, MCP-1 and IL-6 in patients undergoing MHD are risk factors for infection. The combined use of hs-CRP, MCP-1 and IL-6 in serum has a significant predictive value for infection in patients undergoing MHD. 


Key words: hemodialysis, infections, risk factors

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