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1、慢性肾功能不全患者血栓调节蛋白与心脑血管并发症关系的探讨作者：李忠心，陈向东作者单位:100020北京，首都医科人学附属北京朝阳医院肾内科【摘要】目的探讨慢性肾功能不全患者血栓调节蛋白(Tm)与心脑血管并发症的关系。方法北京朝阳供院肾内科2005〜2006年期间住院的86例慢性肾脏病患者，按照CKD分期标准划分为肾功能正常'组(GFRM90ml/min)42例和肾功能不全组(GFR<89ml/min)44例。合并心、脑血管疾病的诊断均根据其临床表现、生化指标和冠脉造影或CT、MRI等影像学改变。淸晨空腹采静脉血分别测定血肌肝、胆固醇、甘油三酯、高密度脂蛋口、低密度脂蛋白及血栓调节
2、蛋白。结果慢性肾脏病肾功能不全组Tm水平明显高于肾功能止常组和对照组(PvO05),伴心脑血管并发症患者Tm水平较不伴并发症患者明显升高(PvO05)。将86例患者作为一个整体，进行多元逐步冋归分析，结果显示：血栓调节蛋白、低密度脂蛋白、收缩压和血肌酹分别与慢性肾脏病合并心脑血管并发症密切相关。结论慢性肾脏病功能不全患者血栓调节蛋白升高，血栓调节蛋白与慢性肾脏病合并心脑血管并发症密切相关。【关键词】慢性肾脏病;慢性肾功能不全;血栓调节蛋门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
