【摘要】目的中介素(intermedin，IMD)是一种新型的血管扩张肽，多项研究证实其有抑制肾脏纤维化、改善氧化应激、促进新生血管形成等作用，具有潜在的肾脏保护作用。但目前研究多为动物与细胞等体外实验，缺乏关于人体内源性IMD 水平与作用的研究。本研究探讨维持性血液透析(maintenance hemodialysis, MHD)患者血清中介素的水平及其影响因素。方法选取首都医科大学宣武医院MHD 3个月以上、病情稳定的患者为研究对象。比较MHD患者与健康对照组之间IMD水平的差异，行Pearson相关分析、Spearman 相关分析及多因素线性回归分析探讨MHD 患者IMD 的影响因素。结果MHD 患者的IMD水平低于健康对照组(Z=-7.666, P＜0.001)。单因素分析结果均提示血磷与IMD 自然对数值(Ln IMD)呈负相关(r=- 0.207,P=0.039)。多因素分析结果提示高磷与血清IMD 水平降低相关(β=- 0.198，95% CI：-0.696～-0.006，P=0.046)。结论MHD 患者血清IMD 水平较正常对照降低，高磷与血清IMD 水平降低
独立相关。
【Abstract】Objective Intermedin (IMD) is a novel vasodilator peptide. Many studies have confirmed that IMD also attenuates renal fibrosis, inhibits oxidative stress, promotes angiogenesis and many others. IMD is therefore considered to be a potential renal protective factor. However, most of these functions were derived from in vitro cell experiments and animal studies, without studies on the function of endogenous IMD in humans. This study investigates the level of serum IMD and its influence factors in maintenance hemodialysis (MHD) patients. Methods MHD patients treated in our hospital for more than 3 months with stable clinical condition were enrolled in this study. Serum IMD levels were compared between MHD patients and healthy controls. Linear regression analysis was utilized to explore the influence factors for IMD in MHD patients. Results Serum IMD was significantly lower in MHD patients than in the healthy controls (Z=- 7.666, P<0.001). Univariate analysis displayed that blood phosphorus was negatively correlated with the natural logarithm of serum IMD (Ln IMD) (r=-0.207, P=0.039). Multivariate analysis also found that lower LnIMD was associated with higher serum phosphorus (β=-0.19, 95% CI -0.696～-0.006, P=0.046). Conclusions Serum IMD was lower in MHD patients. Higher serum phosphorus was independently associated with the lower serum IMD in MHD patients.
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