慢性肾脏病患者血清Klotho蛋白与血管功能紊乱的相关性研究

发布时间：2018-05-20 23:08

  本文选题：Klotho蛋白 + 慢性肾脏病　； 参考：《苏州大学》2016年硕士论文

【摘要】：目的探讨慢性肾脏病(CKD)患者血清Klotho蛋白水平及其与血管功能紊乱的相关性。方法选取2014年1月至2014年12月在泰兴市人民医院肾内科住院的慢性肾脏病患者107例,另外选取年龄、性别匹配的20例健康体检者为对照组。采用ELISA法测定血清Klotho蛋白水平,采用彩色多普勒超声检测患者肱动脉血流介导的血管舒张功能(FMD)和颈动脉中膜厚度(cIMT),采用全自动动脉硬化测定仪检测患者踝臂脉搏波速度(baPWV),采用腹部侧位X线片评估患者的腹主动脉钙化(AAC)。比较CKD患者与健康人群血清Klotho蛋白水平的差别;探讨血清Klotho蛋白水平与CKD-MBD、血管功能紊乱的相关性并分析其临床意义。结果1.CKD患者血清Klotho蛋白水平和FMD显著低于健康对照组,而c IMT、baPWV和AAC评分显著高于健康对照组。2.CKD患者血清Klotho蛋白水平与年龄呈负相关,与eGFR呈正相关,随着CKD进展,血清Klotho蛋白水平显著下降。3.CKD患者血清Klotho蛋白水平与1,25-(OH)2-D3及尿磷排泄分数(FEP)呈正相关,与log iPTH呈负相关。4.CKD患者血清Klotho蛋白水平与FMD呈正相关,与baPWV、c IMT及AAC评分呈负相关。5.FMD≥6.0%、baPWV1400cm/s、cIMT1.0mm及AAC评分=0分的患者血清Klotho蛋白水平均显著高于FMD6.0%、baPWV≥1400cm/s、cIMT≥1.0mm及AAC评分0分的患者。6.多因素Logistic回归分析显示年龄(OR=3.63,95%CI:1.75-8.89,P=0.002)、MBP(OR=2.98,95%CI:1.45-7.69,P=0.009)、蛋白尿(OR=1.97,95%CI:1.16-3.73,P=0.022)、血清Klotho蛋白水平(OR=0.60,95%CI:0.39-0.98,P=0.008)是血管钙化的独立预测因子。结论1.与正常人群相比,CKD患者血清Klotho蛋白水平显著降低,并且随着CKD进展,血清Klotho蛋白水平显著降低;2.血清Klotho蛋白水平与年龄、eGFR、iPTH、1,25-(OH)2-D3、FEP及血管功能紊乱的指标(FMD、baPWV、cIMT及AAC)密切相关;3.血清Klotho蛋白水平下降是血管钙化的独立预测因子。
[Abstract]:Objective to investigate the relationship between serum Klotho protein level and vascular dysfunction in patients with chronic kidney disease (CKD). Methods from January 2014 to December 2014, 107 patients with chronic kidney disease were selected from the Department of Renal Medicine, Taixing people's Hospital, and 20 healthy persons with matched age and sex were selected as the control group. The level of serum Klotho protein was measured by ELISA method. The blood flow mediated vasodilation function of brachial artery (FMD) and carotid intima-media thickness (CIMTT) were measured by color Doppler ultrasound. The ankle brachial pulse wave velocities were measured by automatic arteriosclerotic instrument, and the abdominal lateral radiographs were used to detect the velocities of ankle brachial pulse waves. To evaluate the abdominal aortic calcification in patients with AAC. To compare the difference of serum Klotho protein level between CKD patients and healthy people, to explore the relationship between serum Klotho protein level and CKD-MBD, vascular dysfunction, and to analyze its clinical significance. Results the levels of serum Klotho protein and FMD in 1.CKD patients were significantly lower than those in healthy controls, while the serum Klotho protein levels in patients with 1.CKD were significantly higher than those in healthy controls. 2. The serum Klotho protein levels in patients with 1.CKD were negatively correlated with age, and were positively correlated with eGFR, and with the progression of CKD. The serum Klotho protein level was significantly decreased. 3. The serum Klotho protein level was positively correlated with 125-OHH 2-D3 and urine phosphorus excretion fraction (FEP), and negatively correlated with log iPTH. 4. The serum Klotho protein level was positively correlated with FMD in patients with CKD. The serum Klotho protein levels in patients with BaPWV1400cmsIMT 1.0mm and AAC score = 0 were significantly higher than those with FMD6.0 鈮，

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