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1、慢性腎功能不全患者血栓調(diào)節(jié)蛋白與心腦血管并發(fā)癥關(guān)系的探討作者：李忠心，陳向東作者單位:100020北京，首都醫(yī)科人學附屬北京朝陽醫(yī)院腎內(nèi)科【摘要】目的探討慢性腎功能不全患者血栓調(diào)節(jié)蛋白(Tm)與心腦血管并發(fā)癥的關(guān)系。方法北京朝陽供院腎內(nèi)科2005?2006年期間住院的86例慢性腎臟病患者，按照CKD分期標準劃分為腎功能正常'組(GFRM90ml/min)42例和腎功能不全組(GFR<89ml/min)44例。合并心、腦血管疾病的診斷均根據(jù)其臨床表現(xiàn)、生化指標和冠脈造影或CT、MRI等影像學改變。淸晨空腹采靜脈血分別測定血肌肝、膽固醇、甘油三酯、高密度脂蛋口、低密度脂蛋白及血栓調(diào)節(jié)
2、蛋白。結(jié)果慢性腎臟病腎功能不全組Tm水平明顯高于腎功能止常組和對照組(PvO05),伴心腦血管并發(fā)癥患者Tm水平較不伴并發(fā)癥患者明顯升高(PvO05)。將86例患者作為一個整體，進行多元逐步冋歸分析，結(jié)果顯示：血栓調(diào)節(jié)蛋白、低密度脂蛋白、收縮壓和血肌酹分別與慢性腎臟病合并心腦血管并發(fā)癥密切相關(guān)。結(jié)論慢性腎臟病功能不全患者血栓調(diào)節(jié)蛋白升高，血栓調(diào)節(jié)蛋白與慢性腎臟病合并心腦血管并發(fā)癥密切相關(guān)?！娟P(guān)鍵詞】慢性腎臟病;慢性腎功能不全;血栓調(diào)節(jié)蛋門Relationshipbetweenthrombomodulinandcardio-cerebrovascularcomplicationsi
3、npatientswithchronicrenalfailureLIZhong-xin,CHENXiang-dong.DepartmentofNephrology,ChaoyangHospitalofCapitalMedicalUniversity,Beijing100020,China[Abstract]ObjectiveTodeterminetherelationshipbetweenthrombomodulinandcardio-cerebrovascularcomplicationsinpatientswithchronicrenalfailure.MethodsEigh
4、ty-sixchronickidneydiseases(CKD)patientsfromDepartmentofNephrology,ChaoyangHospital.and60healthyvolunteerswereincludedinthisstudy.Eighty-sixCKDpatientsweredividedintorenalfailuregroupandnormalrenalfunctiongroupaccrodingtoCKDstagingstandard?Diagnosisofcardio-cerebrovascularcomplicationswasonth
5、ebasisofclinicalmanifestation,biochemicalindicator,coronaryarteringraphy,CT,MRI,etal.Bloodwasdrawnafteranovernightfast.BloodlevelsofthrombomodulinweremeasuredusingELISAmethod?Therewerealsobloodtesttomeasurecreatinine(Scr),triglycerides(TG),cholesterol(ChoL),low-densitylipoproteincholesterol(L
6、DL),high-densitylipoproteincholesterol(HDL).ResultsThemeanlevelofTmwashigherinchronicrenalfailurepatientsthanthatinnormalrenalfunctionpatientsandinthehealthycontrols(P<005).ThemeanlevelofTmwassignificantlyhigherinchronicrenalfailurepatientswithcardio-cerebrovascularcomplicationsthanthatinpati
7、entswithoutcardio-cerebrovascularcomplications(P<005).MultivariatestepwiseregressioniinalysisshowedthatinCRFpatients,thecorrelationassociatedwithcardio-cerebrovascularcomplicationswereTm,LDL,SBP,Scr.ConclusionSerumthrombomodulinlevelishigheri
