心血管疾病的肾脏损害研究及中西医认识

【作者】 马锐；

【导师】 杜金行；

【作者基本信息】 北京中医药大学 ， 中西医结合内科， 2008， 硕士

【摘要】 本论文主要包括文献综述和临床研究两个部分。文献综述的题目为心血管疾病的肾脏损害研究及中西医结合认识,回顾了近年来国内外对心血管疾病及其相关危险因素对慢性肾脏病的影响及心肾相关疾病的中医认识。临床上长期高血压,心功能不全会导致肾脏损伤,而绝大多数慢性肾脏病患者均伴不同程度的高血压、冠心病等心血管疾病,可见心血管疾病与肾脏病关系密切。本文对心脏和肾脏的生理和病理方面的联系进行了系统分析,在临床上从冠心病、慢性心功能不全、心血管疾病的危险因素三个方面阐述了心血管疾病对慢性肾脏病的影响。通过中医对心肾相交和心肾不交的认识来说明心脏对肾脏的影响。临床研究部分回顾性分析了中日友好医院2006年10月～2008年3月收治的197例急性心肌梗塞患者临床表现、实验室检查结果像,对数据进行单因素分析,结果发现急性心肌梗死后患者的心功能分级(Killip分级)与肾功能分级成正比,患者年龄与肾功能分级成正比。进行多因素分析,结果发现患者年龄、血浆总胆固醇水平与GFR成反比,甘油三酯水平与GFR成正比。结果中甘油三酯水平与GFR成正比的结果与目前大多数临床报道不相符。临床调查结果说明急性心肌梗死后患者肾功能可能会出现某种程度的降低,在处置急性心肌梗死患者时要充分注意肾功能的水平,以防止急性心肌梗死与肾功能不全成为恶性循环。由于本研究病例数较少,而且为回顾性研究,有必要进一步扩大样本例数进行研究。更多还原

【Abstract】 This paper, including literature review and clinical research in two parts.Literature Review on the subject for cardiovascular disease and kidney damage progress in understanding of Integrative Medicine, reviewed the past few years at home and abroad on cardiovascular disease and related risk factors for chronic kidney disease and the impact of heart and kidney disease related to the understanding of Chinese medicine. Clinical long-term high blood pressure, heart function does not lead to kidney damage plenary session, but the vast majority of chronic kidney disease patients caught with varying degrees of hypertension, coronary heart disease and other cardiovascular diseases, cardiovascular disease and that close to kidney disease.In this paper, heart and kidney physiology and pathology of a link analysis, clinical from chronic heart failure, coronary heart disease, cardiovascular disease risk factors on the three aspects of cardiovascular disease on the impact of chronic kidney disease.Chinese medicine through the intersection of heart and kidney and heart and kidney non-payment of understanding to explain the impact of the heart to the kidneys.Clinical studies of the retrospective analysis of the Sino-Japanese Friendship Hospital in October 2006 to March 2008 treated 197 patients with acute myocardial infarction in patients with clinical manifestations, such as laboratory results, the data-analysis, found that patients with acute myocardial infarction Patients with heart function classification (Killip classification) and renal function is directly proportional to grade, age and patients with renal function is directly proportional to grade. Multi-factor analysis, found that patients with age, plasma total cholesterol levels and inversely proportional to GFR, and triglyceride level is directly proportional to GFR. Results in triglyceride levels and GFR is directly proportional to the results of the current majority of clinical reports do not match. Clinical findings that patients with acute myocardial infarction after renal function may be some degree of reduction in the disposal of patients with acute myocardial infarction, renal function should give full attention to the level to prevent acute myocardial infarction and renal insufficiency become a vicious cycle. As the number of cases of this study less, but also for the retrospective study, it is necessary to further expand the number of samples for research.更多还原