本文選題：Klotho蛋白 + 慢性腎臟病　； 參考：《蘇州大學(xué)》2016年碩士論文

【摘要】：目的探討慢性腎臟病(CKD)患者血清Klotho蛋白水平及其與血管功能紊亂的相關(guān)性。方法選取2014年1月至2014年12月在泰興市人民醫(yī)院腎內(nèi)科住院的慢性腎臟病患者107例,另外選取年齡、性別匹配的20例健康體檢者為對照組。采用ELISA法測定血清Klotho蛋白水平,采用彩色多普勒超聲檢測患者肱動脈血流介導(dǎo)的血管舒張功能(FMD)和頸動脈中膜厚度(cIMT),采用全自動動脈硬化測定儀檢測患者踝臂脈搏波速度(baPWV),采用腹部側(cè)位X線片評估患者的腹主動脈鈣化(AAC)。比較CKD患者與健康人群血清Klotho蛋白水平的差別;探討血清Klotho蛋白水平與CKD-MBD、血管功能紊亂的相關(guān)性并分析其臨床意義。結(jié)果1.CKD患者血清Klotho蛋白水平和FMD顯著低于健康對照組,而c IMT、baPWV和AAC評分顯著高于健康對照組。2.CKD患者血清Klotho蛋白水平與年齡呈負(fù)相關(guān),與eGFR呈正相關(guān),隨著CKD進(jìn)展,血清Klotho蛋白水平顯著下降。3.CKD患者血清Klotho蛋白水平與1,25-(OH)2-D3及尿磷排泄分?jǐn)?shù)(FEP)呈正相關(guān),與log iPTH呈負(fù)相關(guān)。4.CKD患者血清Klotho蛋白水平與FMD呈正相關(guān),與baPWV、c IMT及AAC評分呈負(fù)相關(guān)。5.FMD≥6.0%、baPWV1400cm/s、cIMT1.0mm及AAC評分=0分的患者血清Klotho蛋白水平均顯著高于FMD6.0%、baPWV≥1400cm/s、cIMT≥1.0mm及AAC評分0分的患者。6.多因素Logistic回歸分析顯示年齡(OR=3.63,95%CI:1.75-8.89,P=0.002)、MBP(OR=2.98,95%CI:1.45-7.69,P=0.009)、蛋白尿(OR=1.97,95%CI:1.16-3.73,P=0.022)、血清Klotho蛋白水平(OR=0.60,95%CI:0.39-0.98,P=0.008)是血管鈣化的獨立預(yù)測因子。結(jié)論1.與正常人群相比,CKD患者血清Klotho蛋白水平顯著降低,并且隨著CKD進(jìn)展,血清Klotho蛋白水平顯著降低;2.血清Klotho蛋白水平與年齡、eGFR、iPTH、1,25-(OH)2-D3、FEP及血管功能紊亂的指標(biāo)(FMD、baPWV、cIMT及AAC)密切相關(guān);3.血清Klotho蛋白水平下降是血管鈣化的獨立預(yù)測因子。
[Abstract]:Objective to investigate the relationship between serum Klotho protein level and vascular dysfunction in patients with chronic kidney disease (CKD). Methods from January 2014 to December 2014, 107 patients with chronic kidney disease were selected from the Department of Renal Medicine, Taixing people's Hospital, and 20 healthy persons with matched age and sex were selected as the control group. The level of serum Klotho protein was measured by ELISA method. The blood flow mediated vasodilation function of brachial artery (FMD) and carotid intima-media thickness (CIMTT) were measured by color Doppler ultrasound. The ankle brachial pulse wave velocities were measured by automatic arteriosclerotic instrument, and the abdominal lateral radiographs were used to detect the velocities of ankle brachial pulse waves. To evaluate the abdominal aortic calcification in patients with AAC. To compare the difference of serum Klotho protein level between CKD patients and healthy people, to explore the relationship between serum Klotho protein level and CKD-MBD, vascular dysfunction, and to analyze its clinical significance. Results the levels of serum Klotho protein and FMD in 1.CKD patients were significantly lower than those in healthy controls, while the serum Klotho protein levels in patients with 1.CKD were significantly higher than those in healthy controls. 2. The serum Klotho protein levels in patients with 1.CKD were negatively correlated with age, and were positively correlated with eGFR, and with the progression of CKD. The serum Klotho protein level was significantly decreased. 3. The serum Klotho protein level was positively correlated with 125-OHH 2-D3 and urine phosphorus excretion fraction (FEP), and negatively correlated with log iPTH. 4. The serum Klotho protein level was positively correlated with FMD in patients with CKD. The serum Klotho protein levels in patients with BaPWV1400cmsIMT 1.0mm and AAC score = 0 were significantly higher than those with FMD6.0 鈮，

本文編號：1916640