他汀类药物对腹膜透析患者血脂脂联素及瘦素的影响

目的 探讨他汀类药物对非糖尿病腹膜透析患者血脂、脂联素(ADPN)及瘦素(LEP)的影响.方法 纳入2015年5月至2017年9月伴血脂异常非糖尿病腹膜透析患者95例,通过他汀类药物对其干预,随诊1年,前瞻性观察血ADPN、LEP、血脂、甲状旁腺(PTH)等水平变化,充分性指标及心血管事件发生.结果 经过1年随诊,退出8例,最终87例患者完成本研究,其中男33例,女54例,平均年龄(55.5±9.33)岁,体重指数(BMI)(21.18±2.64)kg/m^2,平均腹透时长42.0(22.0,67.0)个月.出现心脑血管终点事件者共3例.LEP基线水平[46.05(16.90,125.00)pg/ml]高于随诊半年及一年水平(P<0.05);ADPN水平在随访半年[12.57ng/ml(10.79,13.65)]高于基线[8.70ng/ml(5.26,11.24)]及随访1年[9.22ng/ml(7.94,10.34)],存在统计学差异,但基线与1年水平无显著差异;LEP/ADPN在随访半年[0.60(0.28,1.36)]高于基线及随诊1年水平(P<0.05).结论 他汀类药物干预后腹膜透析患者瘦素水平随透析时程延长有下降趋势,而脂联素存在波动.

Objective To investigate the effects of statins on serum lipids,adiponectin and leptin in non-diabetic patients with peritoneal dialysis.Methods A prospective study was conducted on 95 non-diabetic peritoneal dialysis patients with dyslipidemia who were enrolled between May 2015 and September 2017.They were treated with statins in 1 year,and the serum levek of ADPN,LEP,lipid,PTH,as well as the adequacy of dialysis and the occurrence of cardiovascular events were recorded during the follow-up.Results A final of 87 patients completed the study,including 33 males and 54 females,with a male to female ratio of 1:1.64,an average age of(55.5±9.33)years,a body mass index of(21.18±2.64)kg/m^2,and an average dialysis time of 42.0(22.0,67.0)months.3 patients progressed to the cardiovascular and cerebrovascular endpoint.LEP[46.05pg/ml(16.90,125.00)]decreased during the 1-year follow-up.Compared to the baseline and 1-yearfollow-up,the level of DPN and LEP/ADPN was higher at half-year follow-up(P<0.05).Conclusion The level of leptin in patients with peritoneal dialysis decreases with the prolongation of dialysis duration after the intervention of statins,while a fluctuation of adiponectin is also observed.