血液透析患者脂代谢紊乱的临床研究

Clinical study on dislipidemia in hemodialysis patients

目的探讨血液透析患者脂代谢紊乱的临床特征及原因。方法检测106例维持性血液透析患者空腹血脂，并对影响血脂水平及有关因素进行分析。结果血液透析患者脂代谢紊乱主要表现为血清甘油三脂（TG）、载脂蛋白B（Apo-LB）水平显著增高，高密度脂蛋白胆固醇（HDLC）显著降低。TG与血清白蛋白（Alb）、透析时体外循环血流量显著负相关（r=-0．398，r=-0．219）；HDLC水平与Kt／V显著相关（r=-0．305）。血液透析患者高血压的发生率为73．6％，心血管病变为25％。伴心血管疾病的血液透析患者TG水平显著高于无心血管疾病者。结论血液透析患者脂代谢紊乱主要表现为TG、Apo-LB水平增高，HDLC水平降低。透析充分及透析时体外循环血流量及血清白蛋白水平影响血脂水平。

Objective To investigate the clinical characteristics and the causes of dislipidemia in hemodialysis patients. Method Fast serum lipid was measured and the causes related to dislipidemia were analyzed in 106 hemodialysis patients. Results Serum triglyceride, apolipoprotein B increased and high density lipoprotein cholesterol（HDLC） deceased significantly. The level of serum triglyceride was relate to serum albumin （r= - 0. 398, P〈0.01） and blood flow rate （r ： - t）. 219, P〈0. 05）, and the level of HDLC was related to Kt/V （r = - 0. 305, P〈0. 01 ） significantly. TG level in patients with cardiovascular disease was higher than that in patients without cardiovascular disease. Conclusions Serum triglyceride, apolipoprotein B increased and HDLC deceased significantly in hemodialysis patients. The level of serum lipid was related to serum albumin, blood flow rate , serum bile acid and adequency of hemodialysis. TG levels in hemodialysis patients with cardiovascular disease were higher than that in hemodialysis patients without cardiovascular disease.