本文關鍵詞：慢性腎衰竭脾腎虧虛證與濕濁瘀血證患者VEGF和TSP-1表達差異的探討　出處：《黑龍江省中醫(yī)藥科學院》2016年碩士論文　論文類型：學位論文

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【摘要】：目的:探討慢性腎衰竭CKD3期、CKD4期患者血清和尿中血管內皮生長因子(vascular endothelial growth factor,VEGF)、血小板反應蛋白1(Thromlx-pondin-1,TSP-1)水平變化與慢性腎衰竭中醫(yī)虛實辯證之間的關系。方法:研究對象均來源于2015年1月至2016年1月黑龍江省中醫(yī)藥科學院腎五科住院和門診患者,將符合入選標準的60名慢性腎衰竭患者分為兩組,其中脾腎虧虛證組28例、濕濁瘀血證組32例。根據患者血肌酐值,改良MDRD公式計算腎小球率過濾,分為CKD3期組和CKD4期組,其中CKD3期組33例,CKD4期組27例,選取健康志愿者共20例作為對照組。研究對象在清晨空腹采靜脈血、留取晨尿,離心,-80℃低溫冰凍保存。采用酶聯免疫吸附(ELISA)法測定慢性腎衰患者和對照健康者血清、尿液中VEGF、TSP-1的濃度。結果:1.與正常對照組比較,脾腎兩虛證組和濕濁瘀血證組血清、尿中VEGF表達明顯增高,TSP-1表達明顯減少,差異具有統計學意義(P0.01),提示VEGF、TSP-1均可能參與了慢性腎衰竭的發(fā)展;2.脾腎兩虛證組與濕濁瘀血證組比較,兩組血清、尿中VEGF、TSP-1水平均無明顯變化,差異無統計學意義(P0.05),提示VEGF、TSP-1表達不能作為辨別本病虛證和實證的指標;3.與CKD3期組比較,CKD4期組血清、尿中VEGF表達均明顯增多,差異有統計學意義(P0.05),與CKD3期組比較,CKD4期組血清、尿中TSP-1表達均明顯減少,差異有統計學意義(P0.05),提示VEGF、TSP-1表達水平變化與慢性腎衰竭的發(fā)生發(fā)展有一定關系。結論:1.VEGF、TSP-1表達不能作為辨別慢性腎衰竭虛證和實證的指標;2.VEGF、TSP-1表達水平變化與慢性腎衰竭的發(fā)生發(fā)展有一定關系。
[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).
【學位授予單位】：黑龍江省中醫(yī)藥科學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.5
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本文編號：1386073