透析膜对维持性血液透析患者脂质代谢的影响

目的 :探讨不同的透析膜对维持性血液透析患者脂质代谢的影响及其意义。方法 :分别检测 2 0例长期应用铜仿膜透析与 2 5例聚砜膜透析患者血清总胆固醇 (TC)、甘油三脂 (TG)、高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)、极低密度脂蛋白 (VLDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白A[Lp(a) ]水平。结果 :与对照组相比 ,铜仿膜透析组和聚砜膜透析组血清TG、TC、ApoB、Lp(a)及TG/HDL水平均明显增加 (P <0 0 1) ,HDL水平明显降低 (P <0 0 5 ) ;与铜仿膜透析组相比 ,聚砜膜透析组血清HDL及ApoAl水平明显增加 (P <0 0 5 ) ,其余指标则没有明显改变 (P>0 0 5 )。另外 ,聚砜膜透析组HDL水平及TC/HDL比值达到动脉硬化水平的百分比较铜仿膜透析组明显降低 (P <0 0 5 )。结论 :长期应用聚砜膜透析可改善透析患者部分脂质代谢指标 ,其确切机制尚有待于进一步研究。

Effects of dialysis membranes on lipid metabolism in maintenance hemodialysis patients

Objective:To investigate the effects of different dialysis membranes on lipid metabolism in maintenance hemodialysis patients Methods:The serum concentrations of total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),low-density lipoprotein cholesterol(LDL),very low-density lipoprotein cholesterol(VLDL),apolipoproteinA1 and B(ApoA1 and ApoB),and lipoprotein(a)[Lp(a)] were meassured in well-matched uremic patients treated with cuprophane (n=20) as control group or polysulfone(n=25) for maintenance hemodialysis Results:Compared with control group,the patients with polysulfone membrane dialysis had significantly higher mean TG,TC,ApoB,Lp(a) concentrations (P<0 01) and TG/HDL rations as well as lower HDL cholesterol concentrations (P<0 05) However,the patients of polysulfone membrane dialysis had significantly higher mean HDL cholesterol and ApoA1 concentrations compared with cuprophane membrane dialysis(P<0 05) Moreover,polysulfone membrane dialysis was associated with a lower prevalence of potentially atherogenic lipid abnormalities such as low HDL cholesterol levels and high TG/HDL rations(P<0 05) Conclusion:Polysulfone membrane dialysis may improve lipid and pipoprotein profiles in maintenance dialysis patients treated for a long time However,its exact mechanism remains to be determined