本文選題：終末期腎臟病 + 血管鈣化　； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討終末期腎臟病（end-stage renal disease, ESRD）患者血清骨硬化蛋白水平與血管鈣化間的關(guān)系，并分析與骨硬化蛋白相關(guān)的臨床因素。 方法：1、收集我院長(zhǎng)期規(guī)律血液凈化的ESRD患者100人并按年齡匹配的方式選取對(duì)照組100人,比較兩組間體質(zhì)指數(shù)（body mass index,BMI）、白蛋白、總膽固醇（total cholesterol, TC）、甘油三酯（triglyceride，TG）、低密度脂蛋白膽固醇（low density lipoprotein cholesterol, LDL-C）、高密度脂蛋白膽固醇（high density lipoprotein cholesterol, HDL-C）、載脂蛋白（α）（apolipoprotein(α), apo(α)）、瓣膜鈣化發(fā)生率、全段甲狀旁腺素（intact parathyroid hormone, iPTH）、降鈣素、血鈣、血磷、血鈣磷乘積、血鎂、血管鈣化積分及血清骨硬化蛋白水平等相關(guān)指標(biāo)的差異，其中血管鈣化積分用多層螺旋CT（multi-slice spiral CT, MSCT）評(píng)估，血清骨硬化蛋白水平用酶聯(lián)免疫法吸附法（enzyme-linkedimmuno sorbent assay，ELISA）方法測(cè)定。2、按骨硬化蛋白平均數(shù)將ESRD患者分成兩組，比較兩組間年齡、性別、高血壓及糖尿病發(fā)病率、TC、TG、LDL-C、HDL-C、瓣膜鈣化發(fā)生率、iPTH、降鈣素、血鈣、血磷、血鎂和血管鈣化積分等指標(biāo)的差異并分析血清骨硬化蛋白的相關(guān)因素。3、按血管鈣化積分（＜3分和≥3分）將ESRD患者分成兩組，比較兩組血清骨硬化蛋白水平的差異。4、采用SPSS19.0進(jìn)行統(tǒng)計(jì)學(xué)分析，，P＜0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：血清骨硬化蛋白水平較低組的ESRD患者其平均年齡、高血壓及糖尿病發(fā)病率、透析時(shí)間、TC、LDL-C、apo(α)、iPTH、血鈣、血磷、血鈣磷乘積及血管鈣化積分均高于血清骨硬化蛋白較高組的ESRD患者，而白蛋白和血鎂水平均低于后者，差異均有統(tǒng)計(jì)學(xué)意義。同時(shí)血清骨硬化蛋白水平與年齡、iPTH、血磷、鈣磷乘積及血管鈣化積分呈負(fù)相關(guān)，與白蛋白、血鎂水平正相關(guān)。血管鈣化積分≥3分組的ESRD患者的血清骨硬化蛋白水平低于血管鈣化積分＜3組的ESRD患者，差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論：1、血管鈣化在ESRD患者中普通存在，且程度較重，高血清骨硬化蛋白水平可能與較低的血管鈣化積分有關(guān)。2、ESRD患者血清骨硬化蛋白水平明顯升高，且與年齡、甲狀旁腺素、血磷、鈣磷乘積及血管鈣化呈負(fù)相關(guān)，與白蛋白、血鎂成正相關(guān)，提示其可作為一個(gè)新的反應(yīng)ESRD患者骨轉(zhuǎn)化水平和血管鈣化程度的指標(biāo)，但其臨床意義還需進(jìn)一步研究。
[Abstract]:Objective: to investigate the relationship between serum osteosclerotic protein level and vascular calcification in patients with end-stage renal disease (ESRD), and to analyze the clinical factors related to osteosclerotic protein. Methods one hundred ESRD patients with long-term regular blood purification in our hospital were collected and the control group was selected according to the age matching method. The body mass index BMIA and albumin were compared between the two groups. Total cholesterol total cholesterol, TCU, triglyceride-@@ Serum calcium and phosphorus product, blood magnesium, vascular calcification score and serum osteosclerotic protein level were compared. The vascular calcification score was evaluated by multilayer spiral CT(multi-slice spiral (MSCT). Serum osteosclerotic protein levels were measured by enzyme linked immunosorbent assay (Elisa) with enzyme-linkedimmuno sorbent assayamo ELISA.The patients with ESRD were divided into two groups according to the average of bone sclerosing protein, and the age and sex of the two groups were compared. The incidence of high blood pressure and diabetes mellitus and the incidence rate of valve calcification were iPTHs, calcitonin, serum calcium, serum phosphorus, TCU TGG LDL-CU HDL-C, the incidence of valvular calcification, and the incidence of cardiac valve calcification. The difference of serum magnesium and vascular calcification score, and the analysis of the related factors of serum osteosclerotic protein. According to the vascular calcification score (< 3 and 鈮

本文編號(hào)：1857273