慢性肾脏病患者血脂、脂蛋白和载脂蛋白分析

Analysis of serum lipids,lipoproteins and apolipoproteins in patients with CKD

目的研究慢性肾脏病(CKD)患者血脂、脂蛋白和载脂蛋白的变化特点。方法选取340例的CKD患者,根据改良的MDRD方程计算肾小球滤过率估值(e GFR),按分期将患者分4组,另选取257名健康体检者作为对照组,检测肾功能和血脂相关指标,并进行统计分析。结果与对照组比较,CKD患者Scr、BUN、UA、Cys-C、TG、TC、LDL-C和Apo B水平明显升高,而CO2-CP却降低,差异均有统计学意义(P<0.01)。随着CKD分期的进展,TG、TC、LDL-C和Apo B水平却呈下降趋势。e GFR与Scr、BUN、Cys-C、UA、TG、TC、LDL-C和Apo B呈负相关,与CO2-CP呈正相关。Scr、BUN、UA、Cys-C和Apo B是影响CKD患者e GFR水平的危险因素。结论 CKD患者血脂异常表现为TG、TC、LDL-C和Apo B升高,有必要加强对CKD患者高血脂的监测和治疗。

Objective This study was aimed to investigate the changes of serum lipids,lipoproteins and apolipoproteins in patients with chronic kidney disease（ CKD）. Methods The 340 patients with CKD were divided into 4 stages according to the modified MDRD formula. 257 normal subjects were collected as the control group. Biochemical indicators about kidney function and lipids were measured and statistically analyzed. Results Compared to the control group,Scr,BUN,UA,Cys- C,TG,TC,LDL- C and Apo B levels of CKD patients increased significantly,while CO2- CP decreased,and the difference had statistical significance（ P〈 0. 01）. With the progression of CKD stages,the levels of TG,TC,LDL- C and Apo B showed a downward trend. e GFR was negatively correlated with Scr,BUN,Cys- C,UA,TG,TC,LDL- C and Apo B,but positively correlated with CO2- CP. Scr,BUN,UA,Cys- C and Apo B were the risk factors of e GFR in the patients with CKD. Conclusion The abnormal blood lipids of CKD patients exhibit as the increase of TG,TC,LDL- C and Apo B. Thus,it is necessary to strengthen the monitoring and treatment of CKD patients with hyperlipidemia.