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维持性血液透析患者血清可溶性白细胞介素-2 受体水平的意义。

The significance of serum levels of soluble interleukin-2 receptor in patients undergoing maintenance hemodialysis.

机构信息

Shanghai Institute of Kidney and Dialysis, Shanghai, China.

Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.

出版信息

Ren Fail. 2020 Nov;42(1):419-427. doi: 10.1080/0886022X.2020.1761388.

Abstract

Elevated serum levels of sIL-2R are commonly observed in patients undergoing maintenance hemodialysis (MHD). However, the clinical implications in these subjects are unclear. This study is aimed to assess the significance of elevated sIL-2R levels in MHD patients. A total of 382 MHD patients were followed-up from September 2016 to December 2019. Patients were divided into two groups: high sIL-2R, with sIL-2R levels ≥2-fold of the upper limit of normal (710 U/ml); and low sIL-2R, with sIL-2R levels < 2-fold the upper limit of normal. The relationships between sIL-2R levels and other clinical parameters, as well as patient prognosis were both assessed. The median concentration of sIL-2R was 1268 U/mL. A total of 372 (97.38%) patients exhibited sIL-2R levels higher than the upper limit of the normal range. Multiple linear regression analysis revealed that monocyte count (β = 0.1571,  = 0.01), and β-MG (β = 0.2635,  < 0.0001), hemoglobin (β = -0.1610,  = 0.001), SCr (β = -0.3471,  < 0.0001), and HDL-C (β = -0.1091,  = 0.029) levels were independent factors influencing serum concentrations of sIL-2R. High sIL-2R was significantly correlated with non-cardiovascular-related mortality (OR 2.97 [95% CI 1.59-5.56;  = 0.001), of which 39 (82.98%) were attributed to infection and/or cancer. Elevated sIL-2R is prevalent in MHD patients and related with several unfavorable parameters. sIL-2R appears to have no ability to predict cardiovascular mortality, which accounts for approximately one-half of all deaths. However, sIL-2R may be beneficial in predicting noncardiovascular mortality.

摘要

血清可溶性白细胞介素 2 受体(sIL-2R)水平升高在接受维持性血液透析(MHD)的患者中很常见。然而,这些患者的临床意义尚不清楚。本研究旨在评估升高的 sIL-2R 水平在 MHD 患者中的意义。

2016 年 9 月至 2019 年 12 月,共对 382 例 MHD 患者进行了随访。患者分为两组:高 sIL-2R 组,sIL-2R 水平≥正常上限的 2 倍(710 U/ml);低 sIL-2R 组,sIL-2R 水平<正常上限的 2 倍。评估了 sIL-2R 水平与其他临床参数以及患者预后之间的关系。

sIL-2R 的中位数浓度为 1268 U/mL。共有 372(97.38%)例患者的 sIL-2R 水平高于正常范围上限。多元线性回归分析显示,单核细胞计数(β=0.1571,P=0.01)、β2-微球蛋白(β=0.2635,P<0.0001)、血红蛋白(β=-0.1610,P=0.001)、血清肌酐(β=-0.3471,P<0.0001)和高密度脂蛋白胆固醇(β=-0.1091,P=0.029)水平是影响血清 sIL-2R 浓度的独立因素。高 sIL-2R 与非心血管相关死亡率显著相关(OR 2.97 [95%CI 1.59-5.56;P=0.001),其中 39 例(82.98%)归因于感染和/或癌症。

升高的 sIL-2R 在 MHD 患者中很常见,与多个不良参数相关。sIL-2R 似乎没有预测心血管死亡率的能力,而心血管死亡率约占所有死亡的一半。然而,sIL-2R 可能有助于预测非心血管死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a681/7269077/0669fa068b34/IRNF_A_1761388_F0001_B.jpg

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