维持性血液透析患者血25（OH）D水平与慢性炎症状态及营养不良的关系

摘要

目的：探讨维持性血液透析（MHD）患者血25（OH）D水平与慢性炎症状态及营养不良的关系。方法：测定承德医学院附属医院血液透析室119例MHD患者血25（OH）D水平，根据25（OH）D的水平分为维生素D缺乏组：25（OH）D ≤15 ng／mL；不足组：15 ng／mL ＜25（OH）D ≤30 ng／mL；正常组：25（OH）D＞30 ng／mL。比较3组患者炎症因子及营养指标的关系。结果：本组患者血25（OH）D水平3．4～45．3 ng／mL （27．5±14．8） ng／mL，维生素缺乏和不足的比例为88．2％。正常组与缺乏和不足组在年龄、炎症因子（IL-6、TNF-α、CRP）、营养指标（Alb、PA、SGA评分）差异均有统计学意义（P ＜0．05）。结论：MHD患者血25（OH）D水平与营养不良的发生存在密切的关系，它可能通过抑制机体慢性炎症状态改善MHD患者的营养状态。%Objective To identify the relationship among serum 25-hydroxyvitamin D[25(OH)D] level, chronic inflammation state and malnutrition in maintenance hemodialysis (MHD) patients. Methods The serum 25 (OH)D level of 119 patients on MHD was detected. All the patients were divided into three groups according to the serum 25(OH)D level. Vitamin D deficiency: 25(OH)D ≤ 15 ng/mL, vitamin D insufficiency: 15 ng/mL <25(OH)D ≤ 30 ng/mL, vitamin D normal: 25(OH)D > 30 ng/mL. Inflammatory factor and nutritive index were compared among the three groups. Result The average of serum 25 (OH)D level was 3.4~45.3 ng/mL (22.5~14.8 ng/mL), and the prevalence of 25 (OH)D deficiency and insufficiency was 88.2%. Significant differences existed in age, inflammatory factor (IL-6, TNF-α, CRP) and nutritive index (Alb, PA, SGA) between 25(OH)D deficiency, insufficiency groups and normal group (P<0.05). Conclusion The serum 25(OH)D level is possibly related to the malnutrition in MHD patients. It may inhibit chronic inflammation state , in which it can promote state of nutrition of MHD patients.