上海地区透析患者血脂改变的调查

The epidemiology survey of lipid profile in dialysis patients in Shanghai

目的 了解连续性不卧床腹膜透析（ＣＡＰＤ）和维持性血液透析（ＭＨＤ）患者血脂水平改变。方法 对ＣＡＰＤ和ＭＨＤ患者血脂水平进行横断面调查，前瞻性观察ＣＡＰＤ和ＭＨＤ对患者血脂的影响。结果ＣＡＰＤ和ＭＨＤ患者血甘油三酯（ＴＧ）和载脂蛋白Ｂ（ａｐｏＢ）均显著增高，血高密度脂蛋白胆固醇（ＨＤＬ－ｃｈ）、ＨＤＬ２、ａｐｏＡ１和卵磷脂酚基胆固醇转移酶（ＬＣＡＴ）均显著低于正常，以上指标在血、腹透组之间差异无显著性意义。ＣＡＰＤ组血浆脂蛋白（Ｌｐ）（ａ）水平显著高于正常组和 ＭＨＤ组；ＣＡＰＤ治疗后，患者血Ｌｐ（ａ）、ａｐｏＥ、ＬＤＬ－ｃｈ和ａｐｏＢ水平显著升高，血透后仅ａｐｏＥ和ａｐｏＢ水平明显升高。结论ＣＡＰＤ和ＭＨＤ患者脂代谢紊乱相当常见，以前者更为突出。

Objective To investigate the blood lipid profile of CAPD and MHD patients in Shangshi. Methods Cross-sectional and prospective study of blood lipids of CAPD and MHD patients was performed. Results Comparing with normal controls, blood TG and apoB increased and HDL-ch, HDL2, apoAl /apoB and LCAT activity decreased significantly in both CAPD and MHD patients. There was no difference of above lipid parameters between these two groups. CAPD patients also had increased blood TC, LDL-ch and Lp (a). Plasma Lp (a) , LDL-ch, apoB and apoE increased significantly after the initiation of CAPD. Increased apoE and apoB was also found in MHD patients. Conclusion Hyperlipidemia is quite common in dialysis patients, which is more severe in CAPD patients.