本文選題：對(duì)比劑誘導(dǎo)的急性腎損傷 + 急診經(jīng)皮冠狀動(dòng)脈介入治療　； 參考：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文

【摘要】：第一部分:急診經(jīng)皮冠狀動(dòng)脈介入治療術(shù)后對(duì)比劑誘導(dǎo)的急性腎損傷的危險(xiǎn)因素分析目的:目前關(guān)于對(duì)比劑誘導(dǎo)的急性腎損傷(contrast-induced acute kidney injury,CI-AKI)的研究主要立足于擇期行經(jīng)皮冠狀動(dòng)脈介入治療(percutaneous coronary intervention,PCI)的患者,而行急診PCI的患者術(shù)后出現(xiàn)CI-AKI的危險(xiǎn)因素目前尚不完全明確。本研究將在中國(guó)人群中探索急診PCI術(shù)后CI-AKI的危險(xiǎn)因素。方法:選取2013年1月至2015年6月于中國(guó)醫(yī)學(xué)科學(xué)院阜外醫(yī)院行急診PCI的患者共1061例納入研究。將所有患者分為CI-AKI組和非CI-AKI組,進(jìn)行單因素和多因素分析確定急診PCI術(shù)后發(fā)生CI-AKI的危險(xiǎn)因素。CI-AKI定義為接觸碘對(duì)比劑后3日內(nèi),與基線水平相比,血肌酐值(serumcreatinine,SCr)增高≥25%或≥0.5 mg/dL(44.2 μ mol/L)。結(jié)果:行急診PCI的患者CI-AKI發(fā)生率為22.7%(241/1061)0Logistic多因素分析顯示體表面積(body surface area,BSA)[OR 0.213,95%CI:0.075-0.607,P=0.004],心肌梗死史[OR 1.642,95%CI:1.079-2.499,P=0.021],術(shù)前左室射血分?jǐn)?shù)(left ventricular ejection fraction,LVEF)[OR 0.969,95%CI:0.944-0.994,P=0.015],術(shù)前血紅蛋白(hemoglobin,Hb)[OR0.988,95%CI:0.976-1.000,P=0.045],術(shù)前估算的腎小球?yàn)V過(guò)率(estimated glomerular filtration rate,eGFR)[OR 1.027,95%CI:1.018-1.037,P0.001],于左前降支(left anterior descending,LAD)置入支架[OR 1.464,95%CI:1.000-2.145,P=0.050]和應(yīng)用利尿劑[OR 1.850,95%CI,1.233-2.777,P=0.003]是行急診PCI的患者術(shù)后發(fā)生CI-AKI的獨(dú)立預(yù)測(cè)因素。結(jié)論:在行急診PCI的患者中,伴有MI史、BSA較小、術(shù)前LVEF、Hb水平較低、術(shù)前eGFR較高、于LAD置入支架以及應(yīng)用利尿劑的患者術(shù)后發(fā)生CI-AKI的風(fēng)險(xiǎn)較高。第二部分:行急診經(jīng)皮冠狀動(dòng)脈介入治療的患者血漿大內(nèi)皮素-1水平與對(duì)比劑誘導(dǎo)的急性腎損傷的相關(guān)性分析目的:隨著經(jīng)皮冠狀動(dòng)脈介入治療(percutaneous coronary intervention,PCI)技術(shù)廣泛應(yīng)用于冠心病的治療,對(duì)比劑誘導(dǎo)的急性腎損傷(contrast-induced acute kidney injury,CI-AKI)已成為冠脈介入治療的嚴(yán)重并發(fā)癥之一。研究證明血管內(nèi)皮功能紊亂是CI-AKI發(fā)生的重要機(jī)制,本研究將探索行急診PCI的冠心病患者血漿大內(nèi)皮素-1水平與術(shù)后CI-AKI的相關(guān)性。方法:選取2013年1月到2015年6月于中國(guó)醫(yī)學(xué)科學(xué)院阜外醫(yī)院行急診PCI的患者共1061例納入研究。根據(jù)大內(nèi)皮素-1分布將患者分為低水平、中等水平和高水平三組,分析三組患者基線資料和介入操作特征,以及三組間CI-AKI發(fā)生率和術(shù)后6月、12月復(fù)合終點(diǎn)事件(包括非致死性心肌梗死、再次血運(yùn)重建、腦卒中和全因死亡)發(fā)生率的差異,并進(jìn)行l(wèi)ogistic分析明確CI-AKI的危險(xiǎn)因素。CI-AKI定義為接觸碘對(duì)比劑后3日內(nèi),與基線水平相比,血肌酐值(serum creatinine,SCr)增高≥ 25%或≥ 0.5 mg/dL(44.2 μ mol/L)。結(jié)果:行急診PCI的患者術(shù)后CI-AKI發(fā)生率為22.7%(241/1061)。CI-AKI發(fā)生率和6月、12月復(fù)合終點(diǎn)發(fā)生率在大內(nèi)皮素-1低、中、高水平的患者中有明顯的統(tǒng)計(jì)學(xué)差異(P分別為0.001,0.001和0.026)。高水平大內(nèi)皮素-1的患者CI-AKI發(fā)生率顯著高于低水平(P0.001)和中等水平者(P=0.008)。校正其他變量后,大內(nèi)皮素-1不論作為連續(xù)性變量還是分類(lèi)變量均顯著增加急診PCI術(shù)后CI-AKI的風(fēng)險(xiǎn)。結(jié)論:高水平大內(nèi)皮素-1與急診PCI患者術(shù)后CI-AKI的發(fā)生密切相關(guān),血管內(nèi)皮功能紊亂可能是CI-AKI發(fā)生發(fā)展的重要機(jī)制。第三部分:急診經(jīng)皮冠狀動(dòng)脈介入治療術(shù)后對(duì)比劑誘導(dǎo)的急性腎損傷新型風(fēng)險(xiǎn)評(píng)估模型目的:目前冠心病患者經(jīng)皮冠狀動(dòng)脈介入治療(percutaneous coronary intervention,PCI)術(shù)后發(fā)生對(duì)比劑誘導(dǎo)的急性腎損傷(contrast-induced acute kidney injury,CI-AKI)的風(fēng)險(xiǎn)評(píng)分系統(tǒng)大多基于行擇期手術(shù)的病例資料,并不完全適用于行急診PCI的患者,而行急診PCI的患者術(shù)后發(fā)生CI-AKI的危險(xiǎn)因素及其累積效應(yīng)尚未在大型隊(duì)列研究中得到很好的探索。本研究的目的是在行急診PCI的患者中建立一種新的CI-AKI風(fēng)險(xiǎn)評(píng)估模型用以評(píng)估急診PCI患者術(shù)后CI-AKI的發(fā)生風(fēng)險(xiǎn),并對(duì)新建立的風(fēng)險(xiǎn)模型進(jìn)行初步驗(yàn)證,以便更好地預(yù)防急診PCI患者術(shù)后CI-AKI的發(fā)生。方法:本研究將2013年1月至2015年6月期間于中國(guó)醫(yī)學(xué)科學(xué)院阜外醫(yī)院行急診PCI的患者共1061例納入研究。按照手術(shù)的時(shí)間將所有入選的患者分為兩組人群:推導(dǎo)并建立新型風(fēng)險(xiǎn)評(píng)分系統(tǒng)的推導(dǎo)組人群(n=761)和對(duì)風(fēng)險(xiǎn)評(píng)分系統(tǒng)進(jìn)行初步驗(yàn)證的驗(yàn)證組人群(n=300)。本研究中CI-AKI定義為以下三者之一:一,與基線血肌酐值(serum creatinine,SCr)相比,患者術(shù)后72小時(shí)內(nèi)SCr升高≥25%;二,與基線SCr相比,患者術(shù)后72小時(shí)內(nèi)SCr升高≥0.5 mg/dL(44.2 μmol/L);三,與基線SCr相比,患者術(shù)后7日內(nèi)SCr升高≥0.5mg/dL(44.2μmol/L)。探索并根據(jù)最適宜急診PCI患者的定義建立此新型風(fēng)險(xiǎn)模型。結(jié)果:根據(jù)CI-AKI的不同定義,急診PCI術(shù)后CI-AKI的發(fā)生率分別為23.5%(定義一即術(shù)后72小時(shí)內(nèi)SCr升高≥25%),4.3%(定義二即術(shù)后72小時(shí)內(nèi)SCr升高≥0.5 mg/dL或44.2 μ mol/L)和7.0%(定義三即術(shù)后7日內(nèi)SCr升高≥0.5 mg/dL或44.2μmol/L)。鑒于定義一的高敏感性和定義二對(duì)晚發(fā)CI-AKI具有較大漏診率,本研究中新型風(fēng)險(xiǎn)模型的建立依據(jù)定義三。在行急診PCI的患者中建立的CI-AKI新型風(fēng)險(xiǎn)評(píng)分系統(tǒng)由6個(gè)變量組成,各變量及賦值為:體表面積1.6 m2(3分),短暫性腦缺血發(fā)作(transient ischemic attack,TIA)/中風(fēng)史(3 分),白細(xì)胞計(jì)數(shù)(white blood cell count,WBC)15.00X 109/L(2 分),估算的腎小球?yàn)V過(guò)率(estimated glomerular filtration rate,eGFR)60ml/min·1.73m2(3 分)或基線 SCr133μmol/L(4 分),應(yīng)用主動(dòng)脈內(nèi)球囊反搏術(shù)(intro-aortic balloon pump,IABP)(3分)和應(yīng)用利尿劑(7分)。新型風(fēng)險(xiǎn)評(píng)分模型無(wú)論在推導(dǎo)組人群還是驗(yàn)證組人群均顯示出了良好預(yù)測(cè)性(推導(dǎo)組人群:c-統(tǒng)計(jì)量=0.846,95%CI:0.791-0.901;驗(yàn)證組人群:c-統(tǒng)計(jì)量=0.845,95%CI:0.788-0.902)。根據(jù)新型風(fēng)險(xiǎn)模型對(duì)急診PCI患者進(jìn)行CI-AKI風(fēng)險(xiǎn)分層:低風(fēng)險(xiǎn)組(≤5分),中等風(fēng)險(xiǎn)組(6至10分),高風(fēng)險(xiǎn)組(11至15分)和極高風(fēng)險(xiǎn)組(≥16分)。在行急診PCI的患者中CI-AKI的發(fā)生率隨著風(fēng)險(xiǎn)分級(jí)的增加呈指數(shù)形式增長(zhǎng)(P0.001)。結(jié)論:新型風(fēng)險(xiǎn)評(píng)分模型應(yīng)用簡(jiǎn)單,可準(zhǔn)確預(yù)測(cè)急診PCI患者術(shù)后CI-AKI的發(fā)生風(fēng)險(xiǎn)并對(duì)患者進(jìn)行CI-AKI風(fēng)險(xiǎn)分層。
[Abstract]:Part one: analysis of the risk factors for acute renal injury induced by contrast agent after percutaneous coronary intervention: the present study of contrast-induced acute kidney injury (CI-AKI) on contrast induced acute renal injury (CI-AKI) is mainly based on selective percutaneous coronary intervention (percutaneous coronary interve). Ntion, PCI) patients, but the risk factors for postoperative CI-AKI in emergency PCI patients are still not completely clear. This study will explore the risk factors of CI-AKI after emergency PCI in Chinese population. Methods: 1061 cases of emergency PCI from January 2013 to June 2015 in Fuwai Hospital of the Chinese Academy of Medical Sciences were included. Patients were divided into CI-AKI group and non CI-AKI group. Single factor and multifactor analysis were used to determine the risk factor for CI-AKI after PCI operation..CI-AKI was defined as the iodine contrast agent within 3 days. The serum creatinine value (serumcreatinine, SCr) increased more than 25% or more than 0.5 mg/dL (44.2 u mol/L) compared with the baseline level. The incidence of 22.7% (241/1061) 0Logistic multivariate analysis showed that the body surface area (body surface area, BSA) [OR 0.213,95%CI:0.075-0.607, P=0.004], [OR 1.642,95%CI:1.079-2.499 in the history of myocardial infarction, P=0.021], preoperative left ventricular ejection fraction. Hemoglobin, Hb [OR0.988,95%CI:0.976-1.000, P=0.045], estimated glomerular filtration rate, eGFR [OR 1.027,95%CI:1.018-1.037, P0.001]. 2.777, P=0.003] is an independent predictor of postoperative CI-AKI in patients with emergency PCI. Conclusion: in patients undergoing emergency PCI, with the history of MI, BSA is smaller, the preoperative LVEF, Hb level is low, the preoperative eGFR is higher, the risk of CI-AKI on the stent and the use of diuretics in patients with LAD is higher. The second part: emergency percutaneous coronary movement Correlation analysis between plasma endothelin -1 level and contrast induced acute renal injury in patients with pulse interventional therapy Objective: with percutaneous coronary intervention (percutaneous coronary intervention, PCI) technique widely used in the treatment of coronary heart disease, the contrast agent induced acute renal injury (contrast-induced acute kidney injury, C) I-AKI) has become one of the serious complications of coronary intervention. The study has proved that vascular endothelial dysfunction is an important mechanism for the occurrence of CI-AKI. This study will explore the correlation between the level of plasma endothelin -1 in patients with coronary heart disease in emergency PCI and postoperative CI-AKI. Methods: from January 2013 to June 2015 in the Chinese Academy of Medical Sciences. A total of 1061 patients with PCI were enrolled in the study. According to the -1 distribution of the macroendothelin, the patients were divided into three groups of low, medium and high levels. The baseline data and intervention features of the three groups were analyzed, and the incidence of CI-AKI in the three groups and the combined endpoints of June and December after the operation (including non fatal myocardial infarction, re revascularization, The difference in the incidence of cerebral apoplexy and all cause death, and logistic analysis that the risk factor for CI-AKI was defined as.CI-AKI within 3 days after exposure to the iodine contrast agent, and the serum creatinine (serum creatinine, SCr) increased more than 25% or more than 0.5 mg/dL (44.2 mu mol/L) compared with baseline levels. Results: the incidence of CI-AKI in patients with emergency PCI was 22.7% (2). 41/1061) the incidence of.CI-AKI and the incidence of the compound end point in June and December at the low level of the great endothelin -1 (P was 0.001,0.001 and 0.026). The incidence of CI-AKI in patients with high level endothelin -1 was significantly higher than those of low level (P0.001) and middle level (P=0.008). Correction of other variables, large endothelium -1, either as a continuous variable or a classified variable, significantly increases the risk of CI-AKI after emergency PCI operation. Conclusion: high level endothelin -1 is closely related to the occurrence of postoperative CI-AKI in emergency PCI patients. Vascular endothelial dysfunction may be an important mechanism for the development of CI-AKI. The third part: emergency percutaneous coronary intervention therapy A new risk assessment model for acute renal injury induced by post contrast agents Objective: the risk scoring system for acute renal injury induced by contrast agents (contrast-induced acute kidney injury, CI-AKI) after percutaneous coronary intervention (percutaneous coronary intervention, PCI) in patients with coronary heart disease is mostly based on elective surgery. Case data are not fully applicable to patients with emergency PCI, but the risk factors and cumulative effects of postoperative CI-AKI in emergency PCI patients have not been well explored in large cohort studies. The purpose of this study is to establish a new CI-AKI risk assessment model in emergency PCI patients to assess emergency PCI suffering. The risk of postoperative CI-AKI and a new risk model were preliminarily verified in order to better prevent the occurrence of CI-AKI after operation for emergency PCI patients. Methods: 1061 cases of emergency PCI were enrolled from January 2013 to June 2015 in Fuwai Hospital of the Chinese Academy of Medical Sciences. The selected patients were divided into two groups: the derivation and establishment of a new type of risk scoring system (n=761) and a preliminary verification group (n=300). In this study, CI-AKI was defined as one of the following three: one, compared with baseline serum creatinine (serum creatinine, SCr), SCr increased within 72 hours after the operation. More than 25%, two, compared with baseline SCr, the SCr increased more than 0.5 mg/dL (44.2 mu mol/L) within 72 hours after the operation; three, compared with baseline SCr, the patients were higher than 0.5mg/dL (44.2 mu mol/L) within 7 days after operation. Explore and establish this new risk model according to the definition of the most appropriate emergency PCI patients. The incidence of SCr was 23.5% (defined as higher than 25% within 72 hours after the operation), 4.3% (definition two that SCr increased more than 0.5 mg/dL or 44.2 mol/L within 72 hours after operation) and 7% (definition three, SCr elevation above 0.5 mg/dL or 44.2 mol/L within 72 days after operation). In view of the Gao Mingan nature of the first definition and the greater leakage rate for late CI-AKI The establishment of a new risk model in the study was based on definition three. The new CI-AKI risk scoring system established in the patients undergoing emergency PCI was composed of 6 variables. The variables and assignments were: body surface area 1.6 M2 (3), transient ischemic attack (transient ischemic attack, TIA) / stroke history (3), leukocyte count (white blood cell count, WB) C) 15.00X 109/L (2), estimated glomerular filtration rate (estimated glomerular filtration rate, eGFR) 60ml/min 1.73m2 (3) or baseline mol/L (4). Intra aortic balloon counterpulsation (3) and diuretic (7). The new risk score model is in the derivation group or the test The group showed good predictability (derivation group: c- statistics =0.846,95%CI:0.791-0.901; verifying group: c- statistics =0.845,95%CI:0.788-0.902). CI-AKI risk stratification for emergency PCI patients based on the new risk model: low risk group (less than 5), medium risk group (6 to 10), high risk group (11 to 15 points) and high level. The risk group (> 16). The incidence of CI-AKI in the emergency PCI patients increased exponentially with the increase of risk classification (P0.001). Conclusion: the new risk scoring model is simple to predict the risk of CI-AKI after the operation of emergency PCI patients and to make CI-AKI risk stratification for the patients.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R541.4;R692.5

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蔣仕林;急性腎損傷診斷和治療(附48例分析)[J];廣西醫(yī)學(xué);2002年09期

2 廖昌興;盧曉玲;曾憲鳳;;基層醫(yī)院獲得性急性腎損傷的臨床特征[J];內(nèi)科;2007年04期

3 劉天戟;韓冬梅;;125例急性腎損傷診治體會(huì)[J];中國(guó)實(shí)驗(yàn)診斷學(xué);2007年09期

4 張琳琳;周樹(shù)生;劉寶;;急性腎損傷早期診斷生物標(biāo)記物的研究進(jìn)展[J];中國(guó)急救復(fù)蘇與災(zāi)害醫(yī)學(xué)雜志;2008年12期

5 謝潮鑫;孟猛;朱敏敏;蔣蘭麗;;急性腎損傷50例臨床分析[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2008年12期

6 唐舸;;主動(dòng)脈夾層動(dòng)脈瘤并急性腎損傷4例[J];中國(guó)血液凈化;2009年05期

7 梅長(zhǎng)林;;加強(qiáng)急性腎損傷的基礎(chǔ)及臨床研究,不斷提高診治水平[J];上海醫(yī)學(xué);2009年03期

8 張益民;;急性腎損傷的遠(yuǎn)期預(yù)后[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2009年07期

9 張小剛;張小麗;;36例急性腎損傷病因及預(yù)后分析[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2010年04期

10 戴暉;;47例老年慢性腎臟病合并急性腎損傷相關(guān)因素的分析[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2010年06期

相關(guān)會(huì)議論文 前10條

1 王琴;牟姍;嚴(yán)玉澄;顧樂(lè)怡;朱銘力;周文彥;施蓓莉;倪兆慧;;院內(nèi)慢性腎臟病基礎(chǔ)上急性腎損傷的調(diào)查[A];第十一屆全國(guó)中西醫(yī)結(jié)合腎臟病學(xué)術(shù)會(huì)議論文匯編[C];2010年

2 李雪梅;;藥物導(dǎo)致的急性腎損傷[A];中華醫(yī)學(xué)會(huì)腎臟病學(xué)分會(huì)2010學(xué)術(shù)年會(huì)專(zhuān)題講座匯編[C];2010年

3 周奕菁;徐宏;;慢性腎臟病基礎(chǔ)上的急性腎損傷的相關(guān)因素分析[A];2007年浙滬兩地腎臟病學(xué)術(shù)年會(huì)資料匯編[C];2007年

4 劉朋飛;馮業(yè)童;董超;劉迪;吳璇;吳昊昱;石毅;周余來(lái);;骨髓間充質(zhì)干細(xì)胞聯(lián)合維生素E對(duì)急性腎損傷的治療研究[A];第三屆泛環(huán)渤海（七省二市）生物化學(xué)與分子生物學(xué)會(huì)——2012年學(xué)術(shù)交流會(huì)論文集[C];2012年

5 何飛;張均;盧中秋;高慶齡;沙杜鵑;范國(guó)峰;裴力剛;;冠狀動(dòng)脈支架植入術(shù)后急性腎損傷的危險(xiǎn)因素和預(yù)后分析[A];中華醫(yī)學(xué)會(huì)急診醫(yī)學(xué)分會(huì)第十六次全國(guó)急診醫(yī)學(xué)學(xué)術(shù)年會(huì)論文集[C];2013年

6 韓國(guó)鋒;高晶;顧勇;孫晶;張金元;;203例急性腎損傷流行病學(xué)分析[A];《中華急診醫(yī)學(xué)雜志》第八屆組稿會(huì)暨急診醫(yī)學(xué)首屆青年論壇論文匯編[C];2009年

7 王琴;倪兆慧;牟姍;嚴(yán)玉澄;顧樂(lè)怡;戴慧莉;朱銘力;施蓓莉;車(chē)妙琳;吳青偉;;尿白介素-18在慢性腎臟病基礎(chǔ)上急性腎損傷診斷中的意義[A];第10屆全國(guó)中西醫(yī)結(jié)合腎臟病學(xué)術(shù)會(huì)議論文匯編[C];2009年

8 李家瑞;由希雷;;急性腎損傷的營(yíng)養(yǎng)治療[A];中華醫(yī)學(xué)會(huì)第12次全國(guó)內(nèi)科學(xué)術(shù)會(huì)議論文匯編[C];2009年

9 閆素英;;急性腎損傷[A];2010全國(guó)中西醫(yī)結(jié)合危重病、急救醫(yī)學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2010年

10 陳香美;謝院生;;急性腎損傷的修復(fù)再生[A];第十一屆全國(guó)中西醫(yī)結(jié)合腎臟病學(xué)術(shù)會(huì)議論文匯編[C];2010年

相關(guān)重要報(bào)紙文章 前10條

1 記者 譚嘉;急性腎損傷防治應(yīng)城鄉(xiāng)有別[N];健康報(bào);2013年

2 湖南省人民醫(yī)院 主任醫(yī)師 梁玉梅 主治醫(yī)師 陳a音;濫用抗生素引發(fā)急性腎損傷[N];大眾衛(wèi)生報(bào);2013年

3 ;藥物對(duì)體外沖擊波碎石術(shù)所致老年人急性腎損傷的防護(hù)作用[N];中國(guó)醫(yī)藥報(bào);2003年

4 記者 唐聞佳;兩成急性腎損傷源自亂吃藥[N];文匯報(bào);2011年

5 本報(bào)記者 朱國(guó)旺;急性腎衰要早期診治規(guī)范用藥[N];中國(guó)醫(yī)藥報(bào);2008年

6 海上飛魚(yú);透析,并非越多越好[N];醫(yī)藥經(jīng)濟(jì)報(bào);2008年

7 駐京記者　 王丹;高端CT對(duì)比劑臨床使用悄然升溫[N];醫(yī)藥經(jīng)濟(jì)報(bào);2007年

8 本報(bào)記者 朱國(guó)旺;黏度在對(duì)比劑腎病發(fā)生中具有重要意義[N];中國(guó)醫(yī)藥報(bào);2009年

9 本報(bào)記者 李穎;警惕慢性腎臟病流行[N];科技日?qǐng)?bào);2013年

10 記者 朱國(guó)旺;對(duì)比劑安全性比成像效果更重要[N];中國(guó)醫(yī)藥報(bào);2010年

相關(guān)博士學(xué)位論文 前10條

1 陳純波;急性失代償性心力衰竭引起慢性腎臟病患者的急性腎損傷：尿血管緊張素原的預(yù)測(cè)作用及預(yù)后價(jià)值[D];南方醫(yī)科大學(xué);2014年

2 周蒙;PROGRANULIN在急性腎損傷中的作用及機(jī)制研究[D];山東大學(xué);2016年

3 杞少華;骨髓間充質(zhì)干細(xì)胞對(duì)順鉑所致大鼠急性腎損傷的保護(hù)作用和分子機(jī)制[D];武漢大學(xué);2013年

4 蔣春明;抑制糖原合成酶激酶3β誘導(dǎo)巨噬細(xì)胞表型轉(zhuǎn)化及其對(duì)組織損傷的保護(hù)作用[D];南京大學(xué);2016年

5 趙維;鹽酸戊乙奎醚預(yù)先給藥對(duì)大鼠橫紋肌溶解致急性腎損傷的影響及其相關(guān)機(jī)制的研究[D];中國(guó)人民解放軍醫(yī)學(xué)院;2016年

6 孫凱;肝移植術(shù)中靜脈靜脈轉(zhuǎn)流對(duì)術(shù)后急性腎損傷的保護(hù)作用[D];浙江大學(xué);2016年

7 劉遠(yuǎn)輝;miRNA-20a靶向Atg7影響的自噬對(duì)造影劑誘導(dǎo)的急性腎損傷的機(jī)制研究及新的急性腎損傷危險(xiǎn)因素探討[D];南方醫(yī)科大學(xué);2016年

8 李建中;Rictor/mTORC2在急性與慢性腎損傷中作用及機(jī)制的研究[D];南京醫(yī)科大學(xué);2016年

9 關(guān)雪晶;Klotho對(duì)缺血再灌注急性腎損傷中細(xì)胞自噬的作用及其機(jī)制研究[D];上海交通大學(xué);2015年

10 王璇;不同藥物聯(lián)合預(yù)防泛影葡胺誘導(dǎo)急性腎損傷的機(jī)制研究[D];天津醫(yī)科大學(xué);2016年

相關(guān)碩士學(xué)位論文 前10條

1 袁瑩;急診經(jīng)皮冠狀動(dòng)脈介入治療術(shù)后對(duì)比劑誘導(dǎo)的急性腎損傷的危險(xiǎn)因素[D];北京協(xié)和醫(yī)學(xué)院;2017年

2 盧海源;Cs菌絲粉對(duì)大鼠膿毒性急性腎損傷中klotho蛋白表達(dá)的影響[D];河北聯(lián)合大學(xué);2014年

3 李萌;血清胱抑素C和雙源CT腎灌注成像在評(píng)估Debakey Ⅰ型主動(dòng)脈夾層圍手術(shù)期急性腎損傷中的價(jià)值[D];河北醫(yī)科大學(xué);2015年

4 潘笑悅;不同劑量順鉑誘導(dǎo)小鼠急性腎損傷模型觀察及生物學(xué)指標(biāo)檢測(cè)[D];新鄉(xiāng)醫(yī)學(xué)院;2015年

5 國(guó)建;急性腎損傷的病因分析及預(yù)后危險(xiǎn)因素探討[D];南方醫(yī)科大學(xué);2015年

6 朱建剛;床旁超聲評(píng)估嚴(yán)重創(chuàng)傷后急性腎損傷的初步研究[D];浙江大學(xué);2015年

7 徐嘉琪;血尿酸升高和RAS抑制劑的使用：兩種非傳統(tǒng)危險(xiǎn)因素與心血管住院患者急性腎損傷的關(guān)系[D];南方醫(yī)科大學(xué);2015年

8 張仙珍;痛風(fēng)性關(guān)節(jié)炎發(fā)生急性腎損傷危險(xiǎn)因素的臨床研究[D];浙江大學(xué);2015年

9 王韋樂(lè);小兒先天性心臟病術(shù)后并發(fā)急性腎損傷危險(xiǎn)因素及腹膜透析應(yīng)用的探討[D];南京大學(xué);2014年

10 李U，

本文編號(hào)：2048737