高通量透析对维持性血液透析患者血脂代谢的影响

Effect of high flux hemodialysis on lipids metabolism in patients with maintenance hemodialysis

目的观察高通量透析对维持性血液透析(MHD)患者血脂代谢的影响。方法将40例MHD患者随机分成高通量透析组(HFPD组,n=20)和低通量透析组(LFHD组,n=20),HFPD组和LFHD组分别使用聚矾膜F60和F6透析器进行血液透析1年,观察两组患者血脂变化情况。结果HFPD组透析后CHOL、TG、LDL降低,HDL升高;LFHD组透析后TG、LDL升高,HDL降低,CHOL则无明显变化;HFPD组和LFPD组透析前血清胆固醇(CHOL)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)均无明显差异(P>0.05),LFHD组透析1年后CHOL、TG、LDL均较透析前升高,而HDL降低(P=0.041);HFPD组透析1年后CHOL,TG,LDL均降低(P=0.035,P=0.037,P=0.045),HDL升高(P=0.035);透析1年后,与LFPD组相比,HFPD组CHOL、TG、LDL明显降低(P=0.005,P=0.007,P=0.045),HDL升高显著(P=0.008),ALB升高显著(P=0.038)。结论高通量透析可以改善MHD患者的血脂代谢。

Objective To observe the effect of high flux hemodialysis （HFHD） using different membrane on lipid metabolism in patients with maintenance hemodialysis. Method Forty patients with maintenance hemodialysis were randomly divided into two groups. Twenty cases were treated with HFHD using F60 dialyser （HFPD group）, and 20 cases were treated with low flux hemodialysis （LFPD） using F6 dialyser （LFHD group）. Results In HFPD group, serum cholesterol （CHOL）, triglyceride （TG）, low-density lipoprotein （LDL） decreased, and highdensity lipoprotein （HDL） increased after the dialysis for one year. In LFHD group, however, serum TG and LDL increased, HDL decreased, and CHOL remained unchanged. At the beginning of hemodialysis, there were no significant differences in serum CHOL, TG, HDL, LDL and albumin （ALB） between the 2 groups （P 〉 0.05）. In LFHD group, serum CHOL, TG and LDL increased and HDL decreased （P = 0.041） after the dialysis for one year, as compared with those before the dialysis. In contrast in HFPD group, serum CHOL, TG and LDL decreased （P = 0.035, 0.037 and 0.045, respectively） and serum HDL increased （P = 0.035） after the dialysis for one year, as compared with those before the dialysis. When comparisons of serum lipids were made between the 2 groups after the dialysis for one year, serum CHOL （P = 0.005）, TG （P = 0.007） and LDL （P = 0.045） were lower, and serum HDL （P = 0.008） and serum ALB （P = 0.038） were higher in HFPD group than in LFPD group. Conclusion HFPD is effective in improving lipid metabolism in hemodialysis patients.