维持性血液透析对血清胆红素与血脂水平的影响

目的 探讨维持性血液透析(MHD)对慢性肾功能衰竭(CRF)尿毒症期患者血清胆红素与血脂水平的影响及临床意义.方法 42例CRF尿毒症期患者分别于血液透析前及持续血液透析半年后测定血清总胆红素(TB),直接胆红素(DB)、间接胆红素(IB)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)及血红蛋白(Hb)浓度、红细胞(RBC)计数,并与健康对照组进行比较.结果 尿毒症组血液透析前TB、DB、IB、Hb、RBC等指标均低于健康对照组(P＜0.01或P＜0.05),血清TG、LDL-C和apoB明显高于对照组(P＜0.01或P＜0.05),HDL-C明显低于对照组(P＜0.01),TC和apoA1虽略高于对照组,但差异无统计学意义(P＞0.05);而透析后TB、DB、IB较透析前下降(P＜0.01或P＜0.05),TC、TG、HDL-C,LDL-C、apoA1、apoB、Hb与RBC无明显变化(P＞0.05).结论 血液透析患者血清胆红素水平的下降、血脂代谢的紊乱是心脑血管并发症的主要危险因素.

Influence of maintenance hemodialysis on serum bilirubin and blood lipid levels

Objective To discuss the influence and clinical significance of maintenance hemodialysis(MHD)on the bilirubin levels in serum and blood lipid in the patients with chronic renal failure(CRF)uremia.Methods To determine serum total bilirubin(TB),direct bilirubin(DB),indirect bilirubin(IB),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(apoA1),apolipoprotein B(apoB)and hemoglobin(Hb),red blood cell(RBC)in 42 cases of CRF uremia before hemodialysis and after half year of hemodialysis and to compare the results with the normal control group.Results Before hemodialysis in CRF uremia group,TB,DB,IB,Hb and RBC were lower than those in the normal control group(P<0.01 or P<0.05),serum TG,LDL-C and apoB were obviously higher than those in the control group(P<0.01 or P<0.05),HDL-C was lower than that in the control group(P<0.01),TC and apoA1 were slightly higher than those in the control group without statistical significance(P>0.05);after hemodialysis,TB,DB and IB dropped compared with those before dialysis(P<0.01 or P<0.05).TC,TG,HDL-C,LDL-C,apoA1,apoB,Hb and RBC had no marked change(P>0.05).Conclusion The desecent of serum bilirubin level and the metabolic disturbances of blood lipid in the patients with hemodialysis are the main risk factors of cardiocerebral vascular complications.