Expression Of Serum Interleukin-33 In Patients With Maintenance Hemodialysis

BackgroundMaintenance Hemodialysis(MHD)is an important means of survival for uremia patients.However,the complications of hemodialysis seriously affect the life quality of patients with MHD.Studies have shown that the micro-inflammatory state of patients with MHD patients is closely related to their poor prognosis.Improving the state of micro-inflammation in patients is not only an important way to improve their life quality and to prolong their life,but also an important research topic for nephrologists.In patients with MHD,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)and other inflammatory factors are more involved in micro-inflammatory state.However,the expression of interleukin-33(IL-33)in patients with MHD has not been reported in domestic and international.ObjectiveThrough the study of the IL-33 expression in patients with MHD,the correlation between IL-33 and the micro-inflammatory state of patients with MHD was discussed in order to provide theoretical basis for clinical diagnosis and treatment.MethodA total of 145 patients with MHD in the Blood Purification Center of The People’s Hospital of XinXiang Medical University in December 2017 who met the inclusion criteria were selected.30 healthy people were selected as the control group.Clinical data and peripheral blood samples of all subjects were collected and tested for IL-33,IL-6,CRP,blood routine,liver and kidney function,blood lipid and blood glucose.SPSS 22.0 was used for statistical analysis.Result1.The levels of IL-33,IL-6 and CRP in the patients with MHD were all higher than those in the control,and the differences were statistically significant(P < 0.05).The levels of IL-33 was positively correlated with the levels of IL-6 and CRP in the patients with MHD(R=0.529,0.235;P < 0.05).In the healthy people,there was no correlation between IL-33 level and IL-6 and CRP levels(R=0.144,0.192;P> 0.05).2.The levels of IL-33,IL-6 and CRP in the high-flux hemodialysis patients were lower than those in low-flux hemodialysis patients,and the differences were statistical significance(P< 0.05).The neutrophil count in high flux hemodialysis patients was lower than that in the low flux hemodialysis patients,while the lymphocyte count was higher than that in the low fiux hemodialysis patients and the differences were statistically significant(P< 0.05).3.The levels of IL-33,IL-6,CRP and platelet count of patients in the hemoglobin standard group were all lower than those in the hemoglobin substandard group,and the differences were statistically significant(P<0.05).The lymphocyte count of the patients in the hemoglobin substandard group was lower than that in the hemoglobin standard group(P<0.05).4.The levels of IL-33,IL-6 and CRP in the patients of the low albumin group(albumin<35g/L)were all higher than those in the patients of normal albumin group(albumin≥35g/L),and the differences were statistically significant(P<0.05).The level of lymphocyte count of patients in the low albumin group were lower than that of the patients in normal albumin group,and the differences were statistically significant(P<0.05).5.The levels of IL-33,IL-6 and CRP of patients in the three groups with different dialysis ages(A:dialysis age≤12 months,B:12 months<dialysis age≤24months,C: dialysis age>24 months)were statistically significant(P<0.05).The levels of IL-33,IL-6 and CRP were the highest in the group C,while the levels of IL-33,CRP were the lowest in the group A,and the levels of IL-6 were the lowest in the group B.6.There was no significant difference in the levels of IL-33,IL-6 and CRP between the elderly patients(age≥60years)and the non-elderly patients(age<60 years)(P>0.05).7.The levels of IL-33,IL-6 and CRP in patients with diabetic nephropathy and MHD were all higher than those in patients with non-diabetic nephropathy,and the differences were statistically significant(P<0.05).Conclusion1.The levels of serum IL-33 increased in patients with MHD and was positively correlated with the levels of IL-6 and CRP.2.Anemia,malnutrition and long dialysis age are important factors for the increase of serum IL-33 levels in patients with MHD.3.The patients with MHD from primary diabetic nephropathy or use low-flux dialyzer are more likely to have micro-inflammatory states and higher IL-33 levels.