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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。方法齐齐哈尔医学院附属第三医院肾内科2006年至2008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(GFR≥90mL/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。清晨空腹采静脉血分别测定血肌酐、胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白及血栓调节蛋白。结果慢性肾脏病肾功能不全组TM水平明显高于肾功能正常组和对照组(P<0.05),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(P<0.05)。将86例患者作为一个整体,进行多元逐步回归分析,结果显示:血栓调节蛋白、低密度脂蛋白、收缩压和血肌酐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。
Objective To investigate the relationship between thrombomodulin (TM) and cardiovascular and cerebrovascular complications in patients with chronic renal failure. Methods 86 patients with chronic kidney disease hospitalized in the Department of Nephrology, the Third Affiliated Hospital of Qiqihar Medical College from 2006 to 2008 were divided into 42 cases of normal renal function group (GFR≥90mL / min) and renal insufficiency group ( GFR ≥ 89mL / min) in 44 cases. Combined heart and cerebrovascular disease diagnosis are based on their clinical manifestations, biochemical parameters and coronary angiography or CT, MRI and other imaging changes. Serum creatinine, cholesterol, triglyceride, high density lipoprotein, low density lipoprotein and thrombomodulin were measured in fasting morning venous blood. Results The levels of TM in chronic renal disease group were significantly higher than those in normal renal function group and control group (P <0.05). The Tm levels in patients with cardiovascular and cerebrovascular complications were significantly higher than those without complications (P <0.05). A total of 86 patients were analyzed by multiple stepwise regression analysis. The results showed that thrombomodulin, low density lipoprotein, systolic blood pressure and serum creatinine were closely related to cardiovascular and cerebrovascular complications in patients with chronic kidney disease. Conclusion Thrombomodulin is elevated in patients with chronic renal failure. Thrombomodulin is closely related to cardiovascular and cerebrovascular complications in patients with chronic kidney disease.