中华皮肤科杂志 ›› 2026, Vol. 59 ›› Issue (11): 1092-1098.doi: 10.35541/cjd.20260216

• 论著·慢性皮肤瘙痒 • 上一篇    下一篇

[开放获取]    维持性血液透析患者血清IgE水平与慢性肾脏病相关瘙痒的关联研究

杜浦正1    吉蕾1    陈尧1    彭蓉2    卢诗洁1    曾琬菲1    刘丁2    李凤仙1   

  1. 1南方医科大学珠江医院麻醉科，广州  510282；2南方医科大学珠江医院器官移植科，广州  510282
  • 收稿日期:2026-04-17 修回日期:2026-10-09 发布日期:2026-11-03
  • 通讯作者: 李凤仙；刘丁 E-mail:lifengxian81@smu.edu.cn; banbybear01@smu.edu.cn
  • 基金资助:
    国家自然科学基金（82471252）；广东省基础与应用基础研究基金（2024A1515010594）

Association between serum IgE levels and chronic kidney disease-associated pruritus in patients on maintenance hemodialysis

Du Puzheng¹, Ji Lei¹, Chen Yao¹, Peng Rong², Lu Shijie¹, Zeng Wanfei¹, Liu Ding², Li Fengxian¹   

  1. ¹Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China; ²Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
  • Received:2026-04-17 Revised:2026-10-09 Published:2026-11-03
  • Contact: Li Fengxian; Liu Ding E-mail:lifengxian81@smu.edu.cn; banbybear01@smu.edu.cn
  • Supported by:
    National Natural Science Foundation of China （82471252）; Guangdong Basic and Applied Basic Research Foundation （2024A1515010594）

PDF

2

摘要： 【摘要】 目的 探讨维持性血液透析患者血清IgE水平与慢性肾脏病相关瘙痒（CKD-aP）的关联。方法 采用横断面研究设计，纳入2024年6 - 12月于南方医科大学珠江医院血液透析中心接受维持性血液透析（≥ 3个月）的慢性肾脏病患者。根据是否存在CKD-aP分为瘙痒组和非瘙痒组，并依据最严重瘙痒数字分级评分将CKD-aP患者进一步分为轻度瘙痒组和中重度瘙痒组。于入组后首次透析前后检测血清IgE水平。采用Mann-Whitney U检验及Kruskal-Wallis H检验比较组间差异，多因素logistic回归模型分析CKD-aP的相关因素，采用受试者操作特征（ROC）曲线评价透析前血清IgE对中重度CKD-aP的判别效能。结果 纳入104例维持性血液透析患者，包括男71例（68.3%），女33例（31.7%），年龄（57.66 ± 12.64）岁。CKD-aP患者60例（57.7%），其中轻度瘙痒者27例（45.0%），中重度瘙痒者33例（55.0%）。瘙痒组患者透析前血清IgE水平高于非瘙痒组［M（Q1，Q3）为90.25（35.70，130.50） IU/ml比37.55（12.38，102.75） IU/ml，Z = -2.96，P = 0.003］，透析后仍高于非瘙痒组［94.40（36.45，151.50） IU/ml比36.80（13.80，111.25） IU/ml，Z = -2.98，P = 0.003］。透析前及透析后，不同瘙痒严重程度患者IgE水平差异均有统计学意义（H = 22.74、24.57，均P < 0.001），其中中重度瘙痒组透析前、透析后血清IgE水平均高于非瘙痒组及轻度瘙痒组（均P < 0.001）。多因素logistic回归分析显示，透析前IgE水平（每增加10 IU/ml， OR = 1.116，95% CI：1.030 ~ 1.207，P = 0.006）及男性（OR = 2.951，95% CI：1.086 ~ 8.019，P = 0.034）与CKD-aP呈正向关联，而肌酐水平与 CKD-aP 呈负向关联（每增加10 μmol/L， OR = 0.977，95% CI：0.958 ~ 0.995，P = 0.014）。透析前血清IgE水平判别中重度CKD-aP的ROC曲线分析显示，曲线下面积为0.791（95% CI：0.700 ~ 0.882，P < 0.001），对应灵敏度为72.7%，特异度为78.9%。结论 维持性血液透析患者血清IgE水平升高与CKD-aP的严重程度相关，且透析前IgE水平为CKD-aP的独立相关因素。

关键词: 瘙痒症, 慢性肾脏病相关瘙痒, 免疫球蛋白E, 维持性血液透析

Abstract: 【Abstract】 Objective To investigate the association between serum IgE levels and chronic kidney disease-associated pruritus （CKD-aP） in patients on maintenance hemodialysis. Methods A cross-sectional study was conducted among patients with chronic kidney disease who had been on maintenance hemodialysis for at least 3 months at the Hemodialysis Center of Zhujiang Hospital, Southern Medical University, from June to December 2024. The patients were divided into a pruritus group and a non-pruritus group according to the presence of CKD-aP, and patients with CKD-aP were further classified into a mild pruritus group and a moderate-to-severe pruritus group based on the Worst Itch Numeric Rating Scale. Serum IgE levels were measured before and after the first dialysis session after enrollment. Intergroup differences were compared using the Mann-Whitney U test and the Kruskal-Wallis H test. Multivariable logistic regression was used to identify factors associated with CKD-aP. Receiver operating characteristic （ROC） curve analysis was performed to assess the discriminative ability of pre-dialysis serum IgE levels for moderate-to-severe CKD-aP. Results A total of 104 patients on maintenance hemodialysis were enrolled, including 71 males （68.3%）and 33 females （31.7%), aged 57.66 ± 12.64 years. CKD-aP was present in 60 patients （57.7%), of whom 27 （45.0%） had mild pruritus and 33 （55.0%） had moderate-to-severe pruritus. Serum IgE levels were significantly higher in the pruritus group than in the non-pruritus group both before dialysis （median ［first quartile, third quartile］: 90.25 ［35.70, 130.50］ IU/ml vs. 37.55 ［12.38, 102.75］ IU/ml; Z = -2.96, P = 0.003） and after dialysis （94.40 ［36.45, 151.50］ IU/ml vs. 36.80 ［13.80, 111.25］ IU/ml; Z = -2.98, P = 0.003）. Significant differences in pre- and post-dialysis IgE levels were observed among patients with different pruritus severity （H = 22.74 and 24.57, respectively, both P < 0.001）, with the moderate-to-severe pruritus group showing significantly higher pre- and post-dialysis IgE levels than the non-pruritus and mild-pruritus groups （all P < 0.001）. Multivariable logistic regression analysis showed that the pre-dialysis IgE level （per 10-IU/ml increase: OR = 1.116, 95% CI: 1.030 - 1.207, P = 0.006） and male sex（OR = 2.951，95% CI: 1.086 - 8.019，P = 0.034） were associated with increased odds of CKD-aP, while the serum creatinine level was associated with decreased odds of CKD-aP （per 10-μmol/L increase: OR = 0.977，95% CI：0.958 - 0.995，P = 0.014）. ROC curve analysis showed that the area under the curve for pre-dialysis serum IgE levels in discriminating moderate-to-severe CKD-aP was 0.791 （95% CI: 0.700 - 0.882, P < 0.001）, with a sensitivity of 72.7% and a specificity of 78.9%. Conclusion Elevated serum IgE levels were associated with the severity of CKD-aP in patients on maintenance hemodialysis, and the pre-dialysis IgE level was independently associated with CKD-aP.

Key words: Pruritus, Chronic kidney disease-associated pruritus, IgE, Maintenance hemodialysis

引用本文

杜浦正 吉蕾 陈尧 彭蓉 卢诗洁 曾琬菲 刘丁 李凤仙. [开放获取]    维持性血液透析患者血清IgE水平与慢性肾脏病相关瘙痒的关联研究[J]. 中华皮肤科杂志, 2026,59(11):1092-1098. doi:10.35541/cjd.20260216

Du Puzheng¹, Ji Lei¹, Chen Yao¹, Peng Rong², Lu Shijie¹, Zeng Wanfei¹, Liu Ding², Li Fengxian¹. Association between serum IgE levels and chronic kidney disease-associated pruritus in patients on maintenance hemodialysis[J]. Chinese Journal of Dermatology, 2026, 59(11): 1092-1098.doi:10.35541/cjd.20260216