CAPD患者血脂异常与残余肾功能的相关研究

The relationship between dyslipidemia and residue renal function in CAPD patients

目的观察连续性不卧床腹膜透析(CAPD)患者血脂异常对残余肾功能(RRF)的影响。方法根据血脂将72例CAPD患者分为胆固醇(TC)增高组、甘油三酯(TG)增高组及二者均增高组与TC、TG正常组,观察残余肾功能以及CAPD治疗18个月内血脂变化。结果①CAPD治疗初期残余肾功能无明显变化(P>0.05)。第12月时,TC增高组RRF较同组透析初月时下降(P<0.05)。TG增高组及TC、TG均增高组的RRF分别与初月时同组RRF比较显著下降(P<0.001)。第18月时3个血脂增高组RRF与TC、TG组比较均有下降(P<0.05)。RRF下降数值与TC(r=0.234,P<0.05)、TG(r=0.528,P<0.05)均呈正相关;②低密度脂蛋白(LDL)显著上升,第18个月与初月比较有明显差异(P<0.05)。脂蛋白a[Lp(a)]显著上升,第6月与初月比较有明显差异(P<0.05),第12、18月分别与初月相比,均继续升高(P<0.01),并且第18月与第6月相比有明显差异(P<0.05)。结论①CAPD患者的RRF随着透析时间的延长而降低。高脂血症与RRF改变值呈正相关,高脂血症对RRF降低有影响;②CAPD患者随着治疗时间的延长出现血脂异常。

Objective To investigate the effect of dyslipidemia on residue renal function（RRF） in patients of continuous ambulatory peritoneal dialysis（CAPD）. Methods Seventy-two patients were divided into 4 groups based on the level of plasma cholesterol and triglyceride, including hypercholesterol group （1^st） ,hypertriglyceridema group（2^nd）, group with both raised（3^rd）, group with normal lipidemia（4^th）. The changes of RRF and lipidemia within 18 months in CAPD patients were observed. Results （1）There was no significant change of RRF at the beginning of therapy （ p 〉 0. 05 ）. The RRF in 12th month was lower than that in 1^st month in 1^st group （P 〈 0.05 ） , which was significant lower in 2^nd and 3^rd group （P〈0. 001 ）. The RRFs in 1^st,2^nd and 3^rd group were all lower than that in 4^th group in 18^th month （P 〈 0.05 ）. The changes of RRF were positive related to the concentration of TC （ r = 0. 234, P 〈 0.05 ） and TG （ r = 0. 528, P 〈 0.05 ） ; （2）The low density lipoprotein （LDL） in 18th month was significant higher than that in 1^st month （ P 〈 0.05 ）. The lipoprotein a [ Lp （a） ] in 6^6h month was higher than that in 1 ^st month （ P 〈0.05） ,and which in 12^th and 18^th month were significant higher than that in 1^st month （P 〈 0.01 ）. Furthermore,the Lp（a） in 18^th month was significant higher than that in 6^th month （P 〈 0.05）. Conclusion （1）The decrease of RRF is time-depended in patients treated by CAPD. Hyperlipemia is positively related to difference of RRF and it effects the reduce of the hyperlipemra;（2）The occurrence of dyshipidema is time-deperded in patients treated by CAPD.