本文選題：VEGF + ET-1��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討不同腹膜轉(zhuǎn)運(yùn)特性對腹膜透析患者腹膜透析流出液中VEGF、ET-1及UA的影響,為保護(hù)腹膜、防治腹膜超濾功能衰竭提供實(shí)驗(yàn)依據(jù)。方法:選取本院2015年12月~2016年12月行PD的住院患者40例,通過判斷腹膜轉(zhuǎn)運(yùn)特性(PET)的結(jié)果,依照PET結(jié)果,將入組PD患者分成2個(gè)組:高轉(zhuǎn)運(yùn)組(高轉(zhuǎn)運(yùn)與高平均轉(zhuǎn)運(yùn)),低轉(zhuǎn)運(yùn)組(低轉(zhuǎn)運(yùn)與低平均轉(zhuǎn)運(yùn))。(1)記錄患者24h的尿量及超濾量;(2)患者血液送至本院檢驗(yàn)科,化驗(yàn)血紅蛋白、血清白蛋白、血鈣、血磷、甲狀旁腺激素、血尿素氮、血肌酐、血鉀、血鈉等生化指標(biāo);(3)依據(jù)公式計(jì)算KT/V為尿素的清除指數(shù),RRF評價(jià)殘余腎功能;(4)同時(shí)用尿酸酶法測腹膜透析流出液中UA,ELISA法測定腹膜透析流出液中VEGF、ET-1的濃度;(5)用t檢驗(yàn)的方法比較兩組患者腹膜透析流出液中VEGF、ET-1、UA的水平,用Pearson相關(guān)分析,分析腹膜透析流出液中VEGF、ET-1、UA與超濾量、尿量的相關(guān)性。結(jié)果:1.與低轉(zhuǎn)運(yùn)組相比,高轉(zhuǎn)運(yùn)組血液中BUN、Scr、Alb濃度明顯降低。2.高轉(zhuǎn)運(yùn)組患者超濾量、RRF、尿量明顯低于低轉(zhuǎn)運(yùn)組。3.高轉(zhuǎn)運(yùn)組腹膜透析流出液中VEGF、UA濃度與低轉(zhuǎn)運(yùn)組相比明顯升高;高轉(zhuǎn)運(yùn)組與低轉(zhuǎn)運(yùn)組相比,ET-1的濃度無差異(P0.05)。4.腹膜透析流出液中VEGF、UA水平與超濾量呈負(fù)相關(guān)(R=-0.402、-0.378,P0.05),腹膜透析流出液中VEGF、UA水平與尿量呈負(fù)相關(guān)(R=-0.323、-0.345,P0.05),而腹膜透析流出液中的ET-1水平與超濾量、尿量之間沒有相關(guān)性(P0.05)。結(jié)論:1.通過本實(shí)驗(yàn)結(jié)果分析證實(shí),腹膜透析流出液中VEGF、UA水平升高會導(dǎo)致腹膜損傷、腹膜纖維化等腹膜透析并發(fā)癥;2.如果降低腹膜透析流出液中VEGF、UA水平,能夠防止腹膜透析纖維化等并發(fā)癥的發(fā)生;3.本實(shí)驗(yàn)完善了引起腹膜透析并發(fā)癥的影響因素,為腹膜透析并發(fā)癥防治的研究提供實(shí)驗(yàn)依據(jù)。
[Abstract]:Objective: to investigate the effects of different peritoneal transport characteristics on VEGFFftET-1 and UA in peritoneal dialysis effluents of peritoneal dialysis patients, in order to provide experimental evidence for protecting peritoneum and preventing and treating peritoneal ultrafiltration failure. Methods: forty patients with PD from December 2015 to December 2016 in our hospital were selected. According to the results of PET, the characteristics of peritoneal transport were determined. PD patients were divided into two groups: high transport group (high transport group and high average transport group) and low transport group (low transport and low average transport group). Serum albumin, serum calcium, blood phosphorus, parathyroid hormone, blood urea nitrogen, serum creatinine, blood potassium, The RRF evaluation of residual renal function with KT / V as urea was calculated according to the formula. At the same time, the concentration of VEGFFET-1 in peritoneal dialysis effluents was determined by using uric acid enzyme method, and the concentration of VEGFFFET-1 in peritoneal dialysis effluents was determined by Elisa) t test was used to determine the concentration of VEGFFET-1 in peritoneal dialysis effluents. Methods the levels of et 1 UA in peritoneal dialysis effluents were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between VEGF et 1 UA and ultrafiltration volume and urine volume in peritoneal dialysis effluents. The result is 1: 1. Compared with the low transport group, the blood BUNN Scr-Alb concentration in the high transport group was significantly lower than that in the low transport group. The RRFs and urine volume in the high transport group were significantly lower than those in the low transport group. The concentration of VEGF UA in peritoneal dialysis effluents in high transport group was significantly higher than that in low transport group, but there was no difference between high transport group and low transport group. The level of VEGFU UA in peritoneal dialysis effluents was negatively correlated with ultrafiltration, but there was no correlation between the level of VEGFU UA and urine volume. However, there was no correlation between the levels of et 1 and ultrafiltration in peritoneal dialysis effluents, and there was no correlation between the levels of VEGFU UA and urine volume (P 0.05), while the levels of VEGFU in peritoneal dialysis effluents were negatively correlated with the volume of urine (P 0.05), while the levels of VEGFU in peritoneal dialysis effluents were negatively correlated with the volume of urine (P 0.05). Conclusion 1. The results of this study confirmed that the elevated level of VEGF UA in peritoneal dialysis effluents would lead to peritoneal injury, peritoneal fibrosis and other peritoneal dialysis complications. If we reduce the level of VEGF UA in peritoneal dialysis effluents, we can prevent complications such as peritoneal dialysis fibrosis. This experiment improved the influencing factors of peritoneal dialysis complications and provided experimental basis for the prevention and treatment of peritoneal dialysis complications.
【學(xué)位授予單位】：山西醫(yī)科大學(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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