血清低密度脂蛋白胆固醇对慢性肾病患者病情进展的影响

Influence of serum low-density lipoprotein cholesterol level on disease progression in patients with chronic kidney disease

目的探讨血清低密度脂蛋白胆固醇对慢性肾病（CKD）患者病情进展的影响。方法选取2012年1月至2014年12月该院门诊规律随访1年以上,年龄18~70岁的1~2期CKD患者115例作为研究对象。根据CKD进展情况,通过筛选将所有患者分为非进展组60例和进展组40例。结果进展组患者女性比例大于非进展组,他汀类药物使用率、高密度脂蛋白胆固醇（LDL-C）达标率、终点估计肾小球滤过率（eGFR）低于非进展组,基线eGFR,终点总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）高于非进展组,差异均有统计学意义（P〈0.05）。结论 LDL-C较基线升高（即水平大于1.075mmol/L）是CKD进展的独立危险因素。因此需要更加严格控制LDL-C达标标准,更加积极的采用药物治疗。

Objective To study the influence of serum low-density lipoprotein cholesterol level on the disease progression in the patients with chronic kidney disease. Methods 115 patients aged 18-70 years old with the stage 1- 2 chronic kidney disease （CKD） and regular outpatient follow up over 1 year from January 2012 to December 2014 were selected as the research subjects. According to the CKD progress,all patients were divided into the progression group（40 cases） and the non-progression group （60 cases）. Results The female proportion in the progression group was more than that in the non-progression group, the use rate of statin drugs,reaching standard rate of high density lipoprotein cholesterol （LDL--C） and end point eGFR were lower than those in the non-progression group,baseline eGFR,end point total cholesterol （TC）,high-density lipoprotein cholesterol （HDL-C） and LDL-C were higher than those in the non progression group,the differences were statistically significant （P〈0.05）. Conclusion LDL-C in- crease from baseline（〉l. 075 mmol/L） is an independent risk factor for the progression of CKD. So it is needed to more strictly control LDL-C reaching standard criteria and more actively adopt the medication therapy.