慢性肾脏病患者血压变化与成纤维细胞生长因子23的关系的研究

发布时间：2018-06-24 15:34

本文选题：慢性肾脏病 + 高血压　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨FGF-23是否与慢性肾脏病的血压升高及其程度有相关性,为更好控制慢性肾脏病患者血压、改善预后寻求新的治疗途径奠定基础,从而降低心脑血管恶性事件发生率及死亡率。方法:选取新疆医科大学第五附属医院肾病科及高血压科2015年9月-2016年12月符合CKD2-5期诊断标准及高血压病诊断标准的非透析CKD患者160例,根据肾小球滤过率(GFR)分为4组,CKD2期53例,CKD3期39例,CKD4期34例,CKD5期34例。记录患者人口学特征:年龄、性别、身高、体重、基础肾脏病等情况。用免疫酶联法测定FGF-23水平,同时测定受检者钙、磷、PTH水平、1,25(OH)2D3、血肌酐、eGFR、动态血压监测。对所得数据进行统计分析。结果:血清FGF-23各组间比较可见血清FGF-23水平逐渐上升,且各期间比较有统计学意义(P0.05);CKD4-5期动态血压24h-SBP、24h-DBP、d-SBP、d-DBP、n-SBP、n-DBP、脉压差及24小时平均心率较CKD2-3期组比较明显上升,差异有统计学意义(P0.05);FGF-23与24h-SBP、24h-DBP、d-SBP、d-DBP、n-SBP、n-DBP、脉压差及24小时平均心率进行Pearson相关分析,所得FGF-23与其存在明显正相关性(P0.001)。结论:FGF-23可能参与到了CKD高血压的发病过程,可作为一个干预指标,对CKD患者合并高血压患者的早期发现、及时干预起到举足轻重的作用,而FGF-23则可作为未来CKD合并高血压患者血压干预的一个新的研究方向。
[Abstract]:Objective: to investigate whether FGF-23 is related to the elevation and degree of blood pressure in patients with chronic kidney disease, so as to lay a foundation for better control of blood pressure and improve prognosis of patients with chronic kidney disease. In order to reduce the incidence of cardiovascular and cerebrovascular malignant events and mortality. Methods: 160 non-dialysis CKD patients who met the CKD2-5 diagnostic criteria and hypertension diagnostic criteria from September 2015 to December 2016 in the Fifth affiliated Hospital of Xinjiang Medical University were selected. According to the glomerular filtration rate (GFR), the patients were divided into 4 groups. There were 53 cases of CKD _ 2 stage and 39 cases of CKD _ 3 stage and 34 cases of CKD _ 4 stage 5. The demographic characteristics of the patients were recorded: age, sex, height, weight, basic kidney disease and so on. The levels of FGF-23, calcium, phosphorus, PTH, serum creatinine (creatinine) 2D3, and ambulatory blood pressure (ABPM) were measured by immunoenzyme linked assay. Statistical analysis of the obtained data. Results: the serum FGF-23 level increased gradually in each group, and there was statistical significance in each period (P0.05). The dynamic blood pressure (24 h-SBP), pulse pressure difference and 24 hour mean heart rate in CKD4-5 phase were significantly higher than those in CKD2-3 stage group. The difference was statistically significant (P0.05) between FGF-23 and 24h-SBPnd-SBPn- SBPnDBP, pulse pressure difference and 24 hour mean heart rate were analyzed by Pearson correlation analysis, and FGF-23 was positively correlated with it (P0.001). Conclusion: FGF-23 may be involved in the pathogenesis of CKD hypertension. It can be used as an intervention index for the early detection and timely intervention of CKD patients with hypertension. FGF-23 may be a new research direction for blood pressure intervention in CKD patients with hypertension in the future.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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