终末期肾衰竭透析患者血脂变化的临床意义

Clinical significance of serum lipid level changes in dialysis patients with end-stage renal failure

目的:观察连续性非卧床腹膜透析(CAPD)和维持性血液透析(MHD)患者血脂水平的变化,探讨其临床意义。方法:对25例CAPD患者和52例MHD患者血脂水平进行测定,并与30例正常人作对照。结果:CAPD和MHD患者6个月后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)较前明显增高,高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(ApoA)较前明显降低,以上指标在CAPD和MHD之间存在显著性差异,两组患者透析前均有明显的低蛋白血症,透析后血浆白蛋白明显降低,CAPD患者更为突出。结论:终末期肾脏病(ESRD)患者脂代谢异常,两种透析方式均不能纠正代谢异常,以腹膜透析更明显。对透析治疗的患者应注意控制血脂异常,以减少心脑血管事件的发生。

Objective：To investigate the changes of serum lipid level in continuous ambulatory peritoneal dialysis（CAPD） and maintains Peritoneal dialysis（MHD） patients,in order to analyze the clinical effects.Methods：The serum lipid levels were determined in 25 patients with CAPD,52 patients with MHD and 30 patients in control group.Results：Both in CAPD and MHD groups, the serum levels of TC,TG,LDL-C,APeB were obviously increased, while HDL-C,ApoA were obviously decreased after dialyses 6 months.There was significant difference between CAPD and MHD groups concerning the above lipid parameters.In both groups, the serum albumin was obviously low before dialysis.Mter long-term dialysis,the serum albumin became lower and it was more severe in CAPD group.Condusion：The serum lipid level was abnormal in end-stage renal disease patients. Both CAPD and MHD could not correct the abnormity of serum lipid levels,especially in CAPD group.So it was necessary to control the abnormity of serum lipid levels,in order to decrease the happening of cardiovascular and cerebrovascular events.