本文選題：慢性腎臟病 + 高甘油三酯腰圍��； 參考：《昆明醫(yī)科大學》2014年碩士論文

【摘要】：目的：慢性腎臟病患者死亡風險增加,而心血管疾病是導致慢性腎臟病患者死亡的主要原因。高甘油三酯腰圍表型是一個簡單而有效的預測心血管風險的指標,因此,本研究以慢性腎臟病患者為研究對象,探討高甘油三酯腰圍表型與亞臨床動脈粥樣硬化的相關性。 方法：收集785名慢性腎臟病患者病史、各項檢查結果,根據高甘油三酯腰圍表型的診斷標準將患者分成三組,第1組為高甘油三酯腰圍表型組、第3組為正常甘油三酯腰圍組,其余患者納入第2組,測量三組患者的頸動脈內中膜厚度,分析高甘油三酯腰圍表型與動脈粥樣硬化的相關性。 結果：在納入的785名慢性腎臟病患者中,慢性腎臟病組患者占13.9%。高甘油三酯腰圍表型組甘油三酯、低密度脂蛋白膽固醇、頸動脈內中膜厚度均高于正常甘油三酯腰圍組。Logistic回歸分析顯示,腎小球濾過率、糖尿病病史、IMT與高甘油三酯腰圍表型正相關,是高甘油三酯腰圍表型的獨立危險因素。 結論：高甘油三酯腰圍表型組患者的LDL-C、TG、IMT均顯著高于正常甘油三酯腰圍表型組,高甘油三酯腰圍與IMT正相關,IMT增加是高甘油三酯腰圍的獨立危險因素。高甘油三酯腰圍表型可作為慢性腎臟病患者心血管風險的預測指標。 目的：腹型肥胖(abdominal obesity, AO)的發(fā)病率逐年升高,而AO是導致CKD患者病情加重、使慢性腎臟病患者心血管發(fā)病率和死亡風險增加的危險因素。本研究以能夠很好地反映腹型肥胖的指標—脂質沉積指數作為切入點,探討它與亞臨床動脈硬化的相關性。 方法：收集778名慢性腎臟病患者的身高、體重、腰圍、臨床病史、各項空腹血脂指標、頸動脈內膜中層厚度,根據公式：(WC-65)×TG(男性)或(WC-58)×TG(女性)計算出患者的脂質沉積指數,用單因素相關分析方法分析部分臨床及生化指標與頸動脈硬化相關的變量,并用多元回歸分析找出頸動脈硬化的預測指標。 結果：在納入的778名慢性腎臟病患者中,單因素相關分析顯示：與頸動脈硬化相關的變量包括：年齡、GFR、血紅蛋白、尿酸、BMI、LAP,其中年齡、尿酸、血紅蛋白、BMI、LAP與頸動脈硬化呈正相關,GFR、血紅蛋白與頸動脈硬化呈負相關。多變量回歸分析顯示：頸動脈IMT的預測指標包括：年齡(P0.01)、高血壓史(P0.01)、BMI(P0.05)、性別(P0.01)和logLAP (P0.05),其中年齡、高血壓史、BMI、logLAP與頸動脈IMT正相關,性別與頸動脈IMT負相關。結論：LAP與頸動脈IMT呈顯著正相關關系,LAP增加將引起IMT增加,進一步加重動脈硬化,導致CKD患者心血管風險增加,LAP可作為CKD患者心血管風險的有效預測指標。
[Abstract]:Objective: to increase the risk of death in patients with chronic kidney disease, and cardiovascular disease is the leading cause of death in patients with chronic kidney disease. High triglyceride waistline phenotype is a simple and effective predictor of cardiovascular risk. Therefore, we studied the relationship between high triglyceride waist circumference phenotype and subclinical atherosclerosis in patients with chronic kidney disease. Methods: 785 patients with chronic kidney disease were collected and examined. According to the diagnostic criteria of high triglyceride waist circumference phenotype, the patients were divided into three groups: the first group was the high triglyceride waistline phenotype group, the third group was the normal triglyceride waist circumference group. The other patients were included in the second group. The carotid intima-media thickness was measured and the correlation between the phenotype of high triglyceride waist circumference and atherosclerosis was analyzed. Results: of the 785 patients with chronic kidney disease, 13.9 were in the chronic kidney disease group. High triglyceride waist circumference phenotype group, triglyceride, low density lipoprotein cholesterol, carotid artery internal media thickness were higher than normal triglyceride waist circumference group. Logistic regression analysis showed that glomerular filtration rate was higher than that of normal triglyceride waist circumference group. IMT was positively correlated with high triglyceride waist circumference phenotype and was an independent risk factor for high triglyceride waist circumference phenotype. Conclusion: high triglyceride waist circumference phenotype group had significantly higher LDL-C TGG IMT than normal triglyceride waist circumference phenotype group. The increase of high triglyceride waist circumference and IMT positive correlation was the independent risk factor of high triglyceride waist circumference. High triglyceride waistline phenotype can be used as a predictor of cardiovascular risk in patients with chronic kidney disease. Objective: the incidence of abdominal obesity is increasing year by year, and AO is the risk factor of increasing cardiovascular morbidity and death risk in patients with CKD. In this study, the index of lipid deposition, which can well reflect abdominal obesity, was used as a starting point to explore the relationship between lipid deposition index and subclinical arteriosclerosis. Methods: the height, weight, waist circumference, clinical history, fasting blood lipid index and carotid intima-media thickness of 778 patients with chronic kidney disease were collected. The index of lipid deposition was calculated according to the formula: WC-65) 脳 TG (male) or WC-58 脳 TG (female). Single factor correlation analysis was used to analyze some clinical and biochemical variables related to carotid atherosclerosis, and multiple regression analysis was used to find out the predictors of carotid atherosclerosis. Results: among the 778 patients with chronic kidney disease, univariate correlation analysis showed that the variables associated with carotid arteriosclerosis included age GFR, hemoglobin, uric acid BMI-LAPs, among which age, uric acid, uric acid, Hemoglobin BMILAP was positively correlated with carotid arteriosclerosis, and hemoglobin was negatively correlated with carotid atherosclerosis. Multivariate regression analysis showed that the predictors of carotid IMT were: age (P 0.01), hypertension (P 0 01), sex (P 0 05) and logLAP (P 0 05). Age, hypertension history and history of hypertension were positively correlated with carotid IMT, and gender was negatively correlated with carotid IMT. Conclusion there is a significant positive correlation between the ratio of% lap and carotid IMT. The increase of lap may lead to the increase of IMT and further increase of arteriosclerosis. Lap can be used as an effective predictor of cardiovascular risk in CKD patients.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R692.5

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