内科医学论文范文
慢性肾功能不全患者血栓调节蛋白与心脑血管并发症关系的探讨
【摘要】 目的 探讨慢性肾功能不全患者血栓调节蛋白(Tm)与心脑血管并发症的关系。方法 北京朝阳医院肾内科2005～2006年期间住院的86例慢性肾脏病患者，按照CKD分期标准划分为肾功能正常组(GFR≥90 ml/min)42例和肾功能不全组(GFR<89 ml/min)44例。合并心、脑血管疾病的诊断均根据其临床表现、生化指标和冠脉造影或CT、MRI等影像学改变。清晨空腹采静脉血分别测定血肌酐、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白及血栓调节蛋白。结果 慢性肾脏病肾功能不全组Tm水平明显高于肾功能正常组和对照组(P<005)，伴心脑血管并发症患者Tm水平较不伴并发症患者明显升高(P<005)。将86例患者作为一个整体，进行多元逐步回归分析，结果显示：血栓调节蛋白、低密度脂蛋白、收缩压和血肌酐分别与慢性肾脏病合并心脑血管并发症密切相关。结论 慢性肾脏病功能不全患者血栓调节蛋白升高，血栓调节蛋白与慢性肾脏病合并心脑血管并发症密切相关。
【关键词】 慢性肾脏病;慢性肾功能不全;血栓调节蛋白
Relationship between thrombomodulin and cardio-cerebro vascular complications in patients with chronic renal failure
LI Zhong-xin，CHEN Xiang-dong.Department of Nephrology，Chaoyang Hospital of Capital Medical University，Beijing 100020，China
[Abstract] Objective To determine the relationship between thrombomodulin and cardio-cerebro vascular complications in patients with chronic renal failure.Methods Eighty-six chronic kidney diseases(CKD) patients from Department of Nephrology，Chaoyang Hospital.and 60 healthy volunteers were included in this study. Eighty-six CKD patients were divided into renal failure group and normal renal function group accroding to CKD staging standard. Diagnosis of cardio-cerebro vascular complications was on the basis of clinical manifestation，biochemical indicator，coronary arteringraphy，CT，MRI，et al. Blood was drawn after an overnight fast. Blood levels of thrombomodulin were measured using ELISA method. There were also blood test to measure creatinine(Scr)，triglycerides(TG)，cholesterol(ChoL)，low-density lipoprotein cholesterol(LDL)，high-density lipoprotein cholesterol(HDL).Results The mean level of Tm was higher in chronic renal failure patients than that in normal renal function patients and in the healthy controls (P<005). The mean level of Tm was significantly higher in chronic renal failure patients with cardio-cerebro vascular complications than that in patients without cardio-cerebro vascular complications(P<005). Multivariate stepwise regression analysis showed that in CRF patients，the correlation associated with cardio-cerebro vascular complications were Tm，LDL，SBP，Scr.Conclusion Serum thrombomodulin level is higher in CRF patients. Serum thrombomodulin level was correlated with cardio-cerebro vascular complications in chronic renal failure patients.
