慢性肾脏病患者血浆中介素的变化及与同型半胱氨酸、胱抑素-C的相关性研究

发布时间：2018-02-03 07:31

本文关键词： 肾功能不全慢性同型半胱氨酸中介素胱抑素-C　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨中介素(IMD)在慢性肾脏病(CKD)时的水平变化及其与同型半胱氨酸(Hcy)、胱抑素-C(Cyc-C)的相关性。方法：检测30例正常人和147例慢性肾脏病患者血浆IMD、ADM和TGF-β1的浓度，患者根据肾小球滤过率分为1-5期，分析三者在不同分期的变化及其与同型半胱氨酸、胱抑素-C的相互关系。结果：1.随着CKD分期的不同，患者血浆中β2微球蛋白（除CKD1期外）、LDL-C（除CKD5期外）、TG、TC、24h尿蛋白定量、BUN（除CKD1期外）、Scr（除CKD1期外）、 Cyc-C、 Hcy、GFR、ADM（除CKD3期外）、TGF-β1水平与对照组相比，差异均有统计学意义（P＜0.05）。HDL仅CKD4期、5期与对照组相比，差异均有统计学意义（P＜0.05）。IMD含量差异无统计学意义（P＞0.05）。2. GFR＞60ml/min的CKD患者中不同病因类型中IMD的含量：与对照组相比，血浆IMD含量在肾病综合征组、IgA肾病组水平明显升高，差异有统计学意义(P0.05)；各组ADM含量与对照组相比，差异无统计学意义(P=0.086)。各组TGF-β1含量均明显高于对照组(P0.05)。3. GFR＞60ml/min的CKD患者中：IgA肾病组：IMD与Cys-C、Hcy均呈显著正相关(R1=R2=0.9，P1=P2=0.037＜0.05)。结论：血浆IMD、ADM和TGF-β1慢性肾脏病进展中呈现一定变化趋势，尤其在IgA肾病早期变化明显，且与血管损伤因子同型半胱氨酸、胱抑素-C具有正相关性，，提示IMD和ADM可能参与CKD血管损伤的病理过程；而TGF-β1在肾纤维化过程中的变化，反映了机体自我调节的作用。
[Abstract]:Objective: to investigate the level of IMD in patients with chronic kidney disease (CKD) and its correlation with homocysteine cystatin (Hcy) and cystatin C (C) -Cyc (C). Methods: the plasma levels of IMD- ADM and TGF- 尾 1 were measured in 30 normal subjects and 147 patients with chronic kidney disease. The patients were divided into 1-5 stages according to the glomerular filtration rate. The changes of the three types in different stages and their relationship with homocysteine and cystatin-C were analyzed. Results 1. With the difference of CKD stage, the plasma 尾 2 microglobulin (尾 2 microglobulin) was measured by 24 h urine protein quantification except for CKD1 stage. The levels of TGF- 尾 1 were compared with those in control group except for CKD1 stage (except for CKD1 phase, Cyc-C, Hcyn GFR + ADM). The level of TGF- 尾 1 was higher than that in control group (except for CKD3 phase), and the level of TGF- 尾 1 was higher than that in control group. All the differences were statistically significant (P < 0.05). HDL was only compared with the control group in CKD4 phase 5. The difference was statistically significant (P < 0.05). There was no significant difference in IMD content (P > 0.05). Levels of IMD in different etiological types of CKD patients with GFR > 60 ml / min: compared with the control group. The level of plasma IMD in Nephrotic syndrome group was significantly higher than that in Nephrotic group (P 0.05). The content of ADM in each group was higher than that in control group. The content of TGF- 尾 1 in each group was significantly higher than that in control group (P 0.05). GFR > 60 ml / min. In the CKD patients with GFR > 60 ml / min, the patients with GFR > 60 ml / min were in the group of CKD with GFR > 60 ml / min. There was a significant positive correlation between Hcy and P _ (1) P _ (2) P _ (2) P _ (2) P _ (1) P _ (2) P _ (2) P _ (2) P _ ( Conclusion: the plasma IMDD-ADM and TGF- 尾 _ 1 have a certain change trend in the progression of chronic kidney disease, especially in the early stage of IgA nephropathy, and are homocysteine with vascular injury factor. The positive correlation of cystatin C suggests that IMD and ADM may be involved in the pathological process of CKD vascular injury. The changes of TGF- 尾 1 in the process of renal fibrosis reflect the role of self-regulation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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