终末期肾脏病患者血清骨硬化蛋白与血管钙化及其它相关因素的分析

发布时间：2018-05-07 14:23

  本文选题：终末期肾脏病 + 血管钙化　； 参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：探讨终末期肾脏病（end-stage renal disease, ESRD）患者血清骨硬化蛋白水平与血管钙化间的关系，并分析与骨硬化蛋白相关的临床因素。 方法：1、收集我院长期规律血液净化的ESRD患者100人并按年龄匹配的方式选取对照组100人,比较两组间体质指数（body mass index,BMI）、白蛋白、总胆固醇（total cholesterol, TC）、甘油三酯（triglyceride，TG）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol, LDL-C）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDL-C）、载脂蛋白（α）（apolipoprotein(α), apo(α)）、瓣膜钙化发生率、全段甲状旁腺素（intact parathyroid hormone, iPTH）、降钙素、血钙、血磷、血钙磷乘积、血镁、血管钙化积分及血清骨硬化蛋白水平等相关指标的差异，其中血管钙化积分用多层螺旋CT（multi-slice spiral CT, MSCT）评估，血清骨硬化蛋白水平用酶联免疫法吸附法（enzyme-linkedimmuno sorbent assay，ELISA）方法测定。2、按骨硬化蛋白平均数将ESRD患者分成两组，比较两组间年龄、性别、高血压及糖尿病发病率、TC、TG、LDL-C、HDL-C、瓣膜钙化发生率、iPTH、降钙素、血钙、血磷、血镁和血管钙化积分等指标的差异并分析血清骨硬化蛋白的相关因素。3、按血管钙化积分（＜3分和≥3分）将ESRD患者分成两组，比较两组血清骨硬化蛋白水平的差异。4、采用SPSS19.0进行统计学分析，，P＜0.05为差异有统计学意义。 结果：血清骨硬化蛋白水平较低组的ESRD患者其平均年龄、高血压及糖尿病发病率、透析时间、TC、LDL-C、apo(α)、iPTH、血钙、血磷、血钙磷乘积及血管钙化积分均高于血清骨硬化蛋白较高组的ESRD患者，而白蛋白和血镁水平均低于后者，差异均有统计学意义。同时血清骨硬化蛋白水平与年龄、iPTH、血磷、钙磷乘积及血管钙化积分呈负相关，与白蛋白、血镁水平正相关。血管钙化积分≥3分组的ESRD患者的血清骨硬化蛋白水平低于血管钙化积分＜3组的ESRD患者，差异有统计学意义。 结论：1、血管钙化在ESRD患者中普通存在，且程度较重，高血清骨硬化蛋白水平可能与较低的血管钙化积分有关。2、ESRD患者血清骨硬化蛋白水平明显升高，且与年龄、甲状旁腺素、血磷、钙磷乘积及血管钙化呈负相关，与白蛋白、血镁成正相关，提示其可作为一个新的反应ESRD患者骨转化水平和血管钙化程度的指标，但其临床意义还需进一步研究。
[Abstract]:Objective: to investigate the relationship between serum osteosclerotic protein level and vascular calcification in patients with end-stage renal disease (ESRD), and to analyze the clinical factors related to osteosclerotic protein. Methods one hundred ESRD patients with long-term regular blood purification in our hospital were collected and the control group was selected according to the age matching method. The body mass index BMIA and albumin were compared between the two groups. Total cholesterol total cholesterol, TCU, triglyceride-@@ Serum calcium and phosphorus product, blood magnesium, vascular calcification score and serum osteosclerotic protein level were compared. The vascular calcification score was evaluated by multilayer spiral CT(multi-slice spiral (MSCT). Serum osteosclerotic protein levels were measured by enzyme linked immunosorbent assay (Elisa) with enzyme-linkedimmuno sorbent assayamo ELISA.The patients with ESRD were divided into two groups according to the average of bone sclerosing protein, and the age and sex of the two groups were compared. The incidence of high blood pressure and diabetes mellitus and the incidence rate of valve calcification were iPTHs, calcitonin, serum calcium, serum phosphorus, TCU TGG LDL-CU HDL-C, the incidence of valvular calcification, and the incidence of cardiac valve calcification. The difference of serum magnesium and vascular calcification score, and the analysis of the related factors of serum osteosclerotic protein. According to the vascular calcification score (< 3 and 鈮

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