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1、慢性腎功能不全患者血栓調(diào)節(jié)蛋白與心腦血管并發(fā)癥關(guān)系的探討來源:醫(yī)學(xué)論文發(fā)表——創(chuàng)新醫(yī)學(xué)網(wǎng)http://www.yixue360.com/ 作者:李忠心,陳向東作者單位:100020北京,首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院腎內(nèi)科 【摘要】目的探討慢性腎功能不全患者血栓調(diào)節(jié)蛋白(Tm)與心腦血管并發(fā)癥的關(guān)系。方法北京朝陽醫(yī)院腎內(nèi)科2005~2006年期間住院的86例慢性腎臟病患者,按照CKD分期標(biāo)準(zhǔn)劃分為腎功能正常組(GFR≥90ml/min)42例和腎功能不全組(GFR<89ml/min)44例。合并心、腦血管疾病的診斷均根據(jù)其臨床表現(xiàn)、生化指標(biāo)和冠脈造影或CT、MRI等影像學(xué)改變。清晨
2、空腹采靜脈血分別測定血肌酐、膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白及血栓調(diào)節(jié)蛋白。結(jié)果慢性腎臟病腎功能不全組Tm水平明顯高于腎功能正常組和對照組(P<005),伴心腦血管并發(fā)癥患者Tm水平較不伴并發(fā)癥患者明顯升高(P<005)。將86例患者作為一個整體,進行多元逐步回歸分析,結(jié)果顯示:血栓調(diào)節(jié)蛋白、低密度脂蛋白、收縮壓和血肌酐分別與慢性腎臟病合并心腦血管并發(fā)癥密切相關(guān)。結(jié)論慢性腎臟病功能不全患者血栓調(diào)節(jié)蛋白升高,血栓調(diào)節(jié)蛋白與慢性腎臟病合并心腦血管并發(fā)癥密切相關(guān)?! 娟P(guān)鍵詞】慢性腎臟病;慢性腎功能不全;血栓調(diào)節(jié)蛋白 Relationshipbetweenthrombom
3、odulinandcardio-cerebrovascularcomplicationsinpatientswithchronicrenalfailure LIZhong-xin,CHENXiang-dong.DepartmentofNephrology,ChaoyangHospitalofCapitalMedicalUniversity,Beijing100020,China [Abstract]ObjectiveTodeterminetherelationshipbetweenthrombomodulinandcardio-cerebrovascularcomplicatio
4、nsinpatientswithchronicrenalfailure.MethodsEighty-sixchronickidneydiseases(CKD)patientsfromDepartmentofNephrology,ChaoyangHospital.and60healthyvolunteerswereincludedinthisstudy.Eighty-sixCKDpatientsweredividedintorenalfailuregroupandnormalrenalfunctiongroupaccrodingtoCKDstagingstandard.Diagnosi
5、sofcardio-cerebrovascularcomplicationswasonthebasisofclinicalmanifestation,biochemicalindicator,coronaryarteringraphy,CT,MRI,etal.Bloodwasdrawnafteranovernightfast.BloodlevelsofthrombomodulinweremeasuredusingELISAmethod.Therewerealsobloodtesttomeasurecreatinine(Scr),triglycerides(TG),cholestero
6、l(ChoL),low-densitylipoproteincholesterol(LDL),high-densitylipoproteincholesterol(HDL).ResultsThemeanlevelofTmwashigherinchronicrenalfailurepatientsthanthatinnormalrenalfunctionpatientsandinthehealthycontrols(P<005).ThemeanlevelofTmwassignificantlyhigherinchronicrenalfailurepatientswithcardio-
7、cerebrovascularcomplicationsthanthatinpatientswithoutcardio-cerebrovascularcomplications(P<005).MultivariatestepwiseregressionanalysisshowedthatinCRFpatients,thecorrelationassociatedwithcardio-cerebrovascularcomplicationswereTm,L