本文關(guān)鍵詞： 腎功能不全 慢性 同型半胱氨酸 中介素 胱抑素-C　出處：《山西醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：探討中介素(IMD)在慢性腎臟病(CKD)時的水平變化及其與同型半胱氨酸(Hcy)、胱抑素-C(Cyc-C)的相關(guān)性。 方法：檢測30例正常人和147例慢性腎臟病患者血漿IMD、ADM和TGF-β1的濃度，患者根據(jù)腎小球濾過率分為1-5期，分析三者在不同分期的變化及其與同型半胱氨酸、胱抑素-C的相互關(guān)系。 結(jié)果：1.隨著CKD分期的不同，患者血漿中β2微球蛋白（除CKD1期外）、LDL-C（除CKD5期外）、TG、TC、24h尿蛋白定量、BUN（除CKD1期外）、Scr（除CKD1期外）、 Cyc-C、 Hcy、GFR、ADM（除CKD3期外）、TGF-β1水平與對照組相比，差異均有統(tǒng)計學意義（P＜0.05）。HDL僅CKD4期、5期與對照組相比，差異均有統(tǒng)計學意義（P＜0.05）。IMD含量差異無統(tǒng)計學意義（P＞0.05）。2. GFR＞60ml/min的CKD患者中不同病因類型中IMD的含量：與對照組相比，血漿IMD含量在腎病綜合征組、IgA腎病組水平明顯升高，差異有統(tǒng)計學意義(P0.05)；各組ADM含量與對照組相比，差異無統(tǒng)計學意義(P=0.086)。各組TGF-β1含量均明顯高于對照組(P0.05)。3. GFR＞60ml/min的CKD患者中：IgA腎病組：IMD與Cys-C、Hcy均呈顯著正相關(guān)(R1=R2=0.9，P1=P2=0.037＜0.05)。 結(jié)論：血漿IMD、ADM和TGF-β1慢性腎臟病進展中呈現(xiàn)一定變化趨勢，尤其在IgA腎病早期變化明顯，且與血管損傷因子同型半胱氨酸、胱抑素-C具有正相關(guān)性，，提示IMD和ADM可能參與CKD血管損傷的病理過程；而TGF-β1在腎纖維化過程中的變化，反映了機體自我調(diào)節(jié)的作用。
[Abstract]:Objective: to investigate the level of IMD in patients with chronic kidney disease (CKD) and its correlation with homocysteine cystatin (Hcy) and cystatin C (C) -Cyc (C). Methods: the plasma levels of IMD- ADM and TGF- 尾 1 were measured in 30 normal subjects and 147 patients with chronic kidney disease. The patients were divided into 1-5 stages according to the glomerular filtration rate. The changes of the three types in different stages and their relationship with homocysteine and cystatin-C were analyzed. Results 1. With the difference of CKD stage, the plasma 尾 2 microglobulin (尾 2 microglobulin) was measured by 24 h urine protein quantification except for CKD1 stage. The levels of TGF- 尾 1 were compared with those in control group except for CKD1 stage (except for CKD1 phase, Cyc-C, Hcyn GFR + ADM). The level of TGF- 尾 1 was higher than that in control group (except for CKD3 phase), and the level of TGF- 尾 1 was higher than that in control group. All the differences were statistically significant (P < 0.05). HDL was only compared with the control group in CKD4 phase 5. The difference was statistically significant (P < 0.05). There was no significant difference in IMD content (P > 0.05). Levels of IMD in different etiological types of CKD patients with GFR > 60 ml / min: compared with the control group. The level of plasma IMD in Nephrotic syndrome group was significantly higher than that in Nephrotic group (P 0.05). The content of ADM in each group was higher than that in control group. The content of TGF- 尾 1 in each group was significantly higher than that in control group (P 0.05). GFR > 60 ml / min. In the CKD patients with GFR > 60 ml / min, the patients with GFR > 60 ml / min were in the group of CKD with GFR > 60 ml / min. There was a significant positive correlation between Hcy and P _ (1) P _ (2) P _ (2) P _ (2) P _ (1) P _ (2) P _ (2) P _ (2) P _ ( Conclusion: the plasma IMDD-ADM and TGF- 尾 _ 1 have a certain change trend in the progression of chronic kidney disease, especially in the early stage of IgA nephropathy, and are homocysteine with vascular injury factor. The positive correlation of cystatin C suggests that IMD and ADM may be involved in the pathological process of CKD vascular injury. The changes of TGF- 尾 1 in the process of renal fibrosis reflect the role of self-regulation.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692

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