慢性肾脏病患者血脂变化相关因素分析

Related factors of dyslipidemia in patients with chronic kidney disease

目的通过分析慢性肾脏病非透析患者不同分期及原发病脂质代谢紊乱特点及其变化相关因素，为临床调脂治疗提供依据。方法对618例慢性肾脏病非透析患者进行回顾性研究，分析血脂特点及其变化相关因素。结果总胆固醇在前4期均高于对照组（P〈0．01），三酰甘油在前4期高于对照组（P〈0.01），高密度脂蛋白在各期均与对照组无差异。相关分析显示患者血总胆固醇与血红蛋白、红细胞压积等呈正相关（P〈0.01），与白蛋白、尿素氮、血肌酐等呈负相关（P〈0．05）。三酰甘油与血红蛋白、红细胞压积等呈正相关（P〈0.01），与年龄、白蛋白、尿素氮、血肌酐等呈负相关（P〈0．05）。高密度脂蛋白与血红蛋白、红细胞压积等呈正相关（P〈0．05），与体质量、尿素氮、血肌酐呈负相关（P〈0．05）。结论慢性肾脏病不同分期患者血脂水平异常与患者年龄、血红蛋白、白蛋白、肾功能等多种因素相关。

Objective To analyze the changes of lipid metabolic disorder characteristics and the related factors of chronic kidney disease（CKD） patientsnot subject to dialysis having the different stages and primary diseases. Methods 618 CKD patients not subject to dialysis were retrospectively studied and analyzed for the features of blood lipids and changes of related factors. Results Total cholesterol （TC） and triglyceride （TG） levels in CKD 1-4 stages were significantly higher than in control group（P〈0.01 ）, but there was no significant difference in high-density lipoprotein-cholesterol （HDL） levels between CKD group and control group. Correlation analysis revealed that diastolic pressure changes, hemoglobin （Hb）, hematocritvalue （Hct）, and total Ca in CKD patients were positively correlated with TC change（P〈0.01）, and the age, albumin, blood urea nitrogen （BUN）, and serum creatinine （SCr） negatively with TC changes （P〈0.05）. Hb, and Hct were positively correlatecl with TG change（P〈0.01 ）, and the age, systolic blood pressure, albumin, BUN and SCr were negatively correla- ted with TG change（P〈0. 05）. Blood pressure, Hb, Hct and total Ca were positively correlated with HDL change（P〈0. 05）, and the weight, BUN, SCr and p3 were negatively correlated with HDL change（P〈0.05）. Conclusions There exists different degrees of dyslipidemia in CKD patients at different stages,which may be related with the patient＇s age, blood pressure change, anemia degree, nutrition, BUN, SCr, glomerular filtration rate, electrolyte and acid-base situation.