慢性肾衰竭脾肾亏虚证与湿浊瘀血证患者VEGF和TSP-1表达差异的探讨

发布时间：2018-01-06 03:23

  本文关键词：慢性肾衰竭脾肾亏虚证与湿浊瘀血证患者VEGF和TSP-1表达差异的探讨　出处：《黑龙江省中医药科学院》2016年硕士论文　论文类型：学位论文

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【摘要】：目的:探讨慢性肾衰竭CKD3期、CKD4期患者血清和尿中血管内皮生长因子(vascular endothelial growth factor,VEGF)、血小板反应蛋白1(Thromlx-pondin-1,TSP-1)水平变化与慢性肾衰竭中医虚实辩证之间的关系。方法:研究对象均来源于2015年1月至2016年1月黑龙江省中医药科学院肾五科住院和门诊患者,将符合入选标准的60名慢性肾衰竭患者分为两组,其中脾肾亏虚证组28例、湿浊瘀血证组32例。根据患者血肌酐值,改良MDRD公式计算肾小球率过滤,分为CKD3期组和CKD4期组,其中CKD3期组33例,CKD4期组27例,选取健康志愿者共20例作为对照组。研究对象在清晨空腹采静脉血、留取晨尿,离心,-80℃低温冰冻保存。采用酶联免疫吸附(ELISA)法测定慢性肾衰患者和对照健康者血清、尿液中VEGF、TSP-1的浓度。结果:1.与正常对照组比较,脾肾两虚证组和湿浊瘀血证组血清、尿中VEGF表达明显增高,TSP-1表达明显减少,差异具有统计学意义(P0.01),提示VEGF、TSP-1均可能参与了慢性肾衰竭的发展;2.脾肾两虚证组与湿浊瘀血证组比较,两组血清、尿中VEGF、TSP-1水平均无明显变化,差异无统计学意义(P0.05),提示VEGF、TSP-1表达不能作为辨别本病虚证和实证的指标;3.与CKD3期组比较,CKD4期组血清、尿中VEGF表达均明显增多,差异有统计学意义(P0.05),与CKD3期组比较,CKD4期组血清、尿中TSP-1表达均明显减少,差异有统计学意义(P0.05),提示VEGF、TSP-1表达水平变化与慢性肾衰竭的发生发展有一定关系。结论:1.VEGF、TSP-1表达不能作为辨别慢性肾衰竭虚证和实证的指标;2.VEGF、TSP-1表达水平变化与慢性肾衰竭的发生发展有一定关系。
[Abstract]:Objective: to study the CKD3 stage of chronic renal failure. Vascular endothelial growth factor (VEGF) in serum and urine of CKD4 patients. Thromlx-pondin-1. TSP-1). The relationship between the level change and the dialectical relationship between deficiency and reality of TCM in chronic renal failure methods: the subjects of the study were from January 2015 to January 2016 in the inpatient and outpatient department of the five departments of Kidney of Heilongjiang Academy of traditional Chinese Medicine. 60 patients with chronic renal failure were divided into two groups: the spleen and kidney deficiency syndrome group (28 cases) and the dampness and turbid blood stasis group (32 cases). Glomerular rate filtration was calculated by modified MDRD formula and divided into CKD3 phase group and CKD4 stage group. Among them, 33 cases in CKD3 phase group were treated with CKD 4 stage group, 27 cases in CKD3 phase group. A total of 20 healthy volunteers were selected as control group. The subjects collected venous blood on an empty stomach in the morning, took morning urine, and centrifuged. VEGF in serum and urine of patients with chronic renal failure and control group were determined by Elisa. The concentration of TSP-1. Results 1. Compared with the normal control group, the expression of VEGF in serum and urine in the spleen and kidney deficiency group and the dampness turbid blood stasis group was significantly increased and the expression of TSP-1 was significantly decreased. The difference was statistically significant (P 0.01), which suggested that VEGF TSP-1 might be involved in the development of chronic renal failure. 2. The levels of TSP-1 in serum and urine of both spleen and kidney deficiency syndrome group and dampness and blood stasis group were not significantly changed, indicating that VEGF was not significantly different between the two groups (P 0.05). The expression of TSP-1 could not be used as an index to distinguish the deficiency syndrome and the empirical evidence of the disease. 3.Compared with CKD3 stage group, the expression of VEGF in urine of stage 4 group was significantly higher than that of stage 4 group of CKD3, the difference was statistically significant (P 0.05), and that of stage 4 group of CKD3 group was higher than that of stage 4 group of CKD3 phase. The expression of TSP-1 in urine was significantly decreased, and the difference was statistically significant (P 0.05), indicating VEGF. Conclusion: 1. The expression of VEGF TSP-1 can not be used as an index to distinguish deficiency syndrome and diagnosis of chronic renal failure. 2. The expression of TSP-1 in VEGF was related to the occurrence and development of chronic renal failure (CRF).
【学位授予单位】：黑龙江省中医药科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5
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