不同的透析膜对血脂代谢的影响

目的 观察透析膜对血脂的影响。方法 入选患者随机分为两组，A组：醋酸纤维膜中空中纤维透析器（1．3m^2)，B组：聚砜膜中空纤维透析器（1.3m^2），观察血脂、脂蛋白及载脂蛋白水平。结果 A组和B组在透析前及透析6个月时血清Ch均高于对照组，但无差异。两组透析前TG升高（P＜0．05），A组TG升高，而B组TG下降，下透析前比较有显著差异（P＜0．01），A组HDL－c透析6个月较透析前降低（P＜0．05）。B组透析前时间延长HDL－c升高，A组Lp(a)、HDL-c及VLDL－c升高更显著，而B组除Lp(a)有升高外，VLDL－c及LDL－c无显著变化。结论 选用聚砜膜透析器可以降低血脂，同时也减低出了由于动脉粥样硬化所 致的脑血管意外的发生。

Influence of dialyzer membrane on blood lipids in hemodialysis patients

Objective To investigate the influence of dialyzer membrane on blood lipids in hemodialysis patients. The purpose of this study was to reduce the incidence of caudiac and cerebrovascular accidents due to atherosclerosis and to improve their vitality. Methods The patients were randomized into two groups: group A: cellulose acetate membrane dialyzer(surface area 1.3m 2), group B: polysulfone capillary dialyzer(surface area 1.3m 2). Blood lipid parameters were evaluated. Results Before dialysis, serum triglyceride(TG) and cholesterol were higher than those of the controls and HDL c was lower. There was no differences between the two groups. After 6 months' dialysis, serum TG increased, HDL c decreased and Lp(a), HDL c and VLDL c were much higher than those before the dialysis in group A. In group B, only Lp(a) increased. There were no changes in VLDL c and HDL c. Conclusion In hemodialysis patients with chronic renal failure, improving the lipid metabolism is able to delay the progressiion of the pathologic changes in the residual nephrons and protect the residual renal function. Polysulfone dialyzers improve the lipid metabolism and decrease the incidence of cardiac and cerebrovascular accidents.