本文選題：維持性血液透析 + FGF-23��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:探究維持性血液透析患者血管鈣化的發(fā)生發(fā)展與血清中成纖維細(xì)胞生長因子-23(FGF-23)及內(nèi)分泌型FGF輔助因子(klotho)水平之間的關(guān)系,為維持性血液透析患者血管鈣化的評估提供一定的理論依據(jù)。方法:本研究以126例維持性血液透析患者作為研究對象,詳細(xì)記錄患者的一般臨床資料,采用胸部X線攝片,心臟、大動脈的超聲檢查對患者的血管鈣化程度進行準(zhǔn)確判斷,并根據(jù)患者血管鈣化程度分組,分為無鈣化、輕度鈣化和重度鈣化組。應(yīng)用ELISA法對患者的血清FGF-23水平以及klotho水平進行檢測,使用Spearman相關(guān)分析探討患者血管鈣化的發(fā)生與血清FGF-23水平以及klotho水平之間的關(guān)系,采用多分類Logistic回歸分析來探討維持性血液透析患者的血管鈣化發(fā)生和發(fā)展的危險因素。結(jié)果:本研究中受試者無鈣化組31例、輕度鈣化組56例、重度鈣化組39例,研究顯示:1.不同程度血管鈣化患者之間的年齡、血清白蛋白水平、血磷、i PTH等均具有顯著性差異(均P0.05);2.不同程度血管鈣化患者之間的血清FGF-23水平以及klotho水平差異顯著(均P0.05)。3.根據(jù)患者血管鈣化的Spearman相關(guān)分析得出結(jié)論:患者的血管鈣化程度與血清FGF-23水平呈正相關(guān)關(guān)系(r=0.550,P=0.000),而與klotho水平呈負(fù)相關(guān)關(guān)系(r=-0.386,P=0.000)。4.維持性血液透析患者的血清高FGF-23水平是獨立的血管鈣化危險因素(OR值為1.031,95%CI為1.010~1.052),而高klotho水平則是保護因素(OR值為0.991,95%CI為0.984~0.998)。結(jié)論:對于維持性血液透析患者,血管鈣化的程度與血清FGF-23及klotho水平之間具有明顯相關(guān)性,且患者的血清FGF-23以及klotho水平是影響其血管鈣化程度的重要因素。
[Abstract]:Objective: to investigate the relationship between the occurrence and development of vascular calcification in maintenance hemodialysis patients and the levels of serum fibroblast growth factor-23FGF-23 and endocrine FGF cofactor klotho. To provide a theoretical basis for the evaluation of vascular calcification in maintenance hemodialysis patients. Methods: 126 patients with maintenance hemodialysis were studied in this study. The general clinical data of the patients were recorded in detail, and the degree of vascular calcification was accurately judged by chest radiography, echocardiography of the heart and great arteries. According to the degree of vascular calcification, the patients were divided into three groups: non calcified group, mild calcified group and severe calcified group. The serum FGF-23 and klotho levels were detected by ELISA method. The relationship between the occurrence of vascular calcification and the serum FGF-23 and klotho levels was investigated by Spearman correlation analysis. Multiclass Logistic regression analysis was used to investigate the risk factors of vascular calcification in maintenance hemodialysis patients. Results: in this study, there were 31 cases in non-calcification group, 56 cases in mild calcification group and 39 cases in severe calcification group. There were significant differences in age, serum albumin level and serum phosphorous I PTH between patients with different degrees of vascular calcification (all P 0.05). There were significant differences in serum FGF-23 and klotho levels among patients with different degrees of vascular calcification (all P 0.05. 3). According to the Spearman correlation analysis of vascular calcification in patients, it was concluded that the degree of vascular calcification was positively correlated with serum FGF-23 level, but negatively correlated with klotho level. The serum high FGF-23 level was an independent risk factor for vascular calcification in maintenance hemodialysis patients. The OR value was 1.031 鹵95 CI 1.010 鹵1.052 渭 m, while the high klotho level was a protective factor. The OR value of high klotho level was 0.991-95 CI 0.984 鹵0.998g. Conclusion: there is a significant correlation between the degree of vascular calcification and the levels of serum FGF-23 and klotho in patients with maintenance hemodialysis, and the levels of serum FGF-23 and klotho are important factors affecting the degree of vascular calcification.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5

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