血液透析患者脂质代谢与机体营养状况的关系

目的: 探讨慢性肾衰血液透析患者血清脂质水平与机体营养状况的关系.方法: 测定44例血液透析患者血红蛋白(hemoglobin HB)、白蛋白(albumin ALB)、甘油三脂(triglyceride TG)、总胆固醇(total cholesterol TC)、高密度脂蛋白(high-density lipoprotein HDL)、载脂蛋白(apolipoprotein A1 ApoA1,apolipoprotein B ApoB)及脂蛋白Lp(a)水平,与健康体检组对照研究. 结果: 血液透析患者组血清TG,TC,ApoB,Lp(a)增高(P<0.05),HDL, ApoA1,ALB,HB降低(P<0.05),有显著性.相关性分析:ALB与HDL,ApoA1正相关,与TG,TC,ApoB负相关;Lp(a)与HB,ALB,ApoA1负相关,与 TG,TC,ApoB正相关.结论: 血液透析患者存在明显的脂质代谢紊乱且与患者长期的贫血和蛋白营养不良相关,可能是导致动脉粥样硬化的诱因.

A Study of the Relationship between Lipid Metabolism and Nutritional Status in Hemodialysis Patients

Objective: To explore the relationship between lipid level and nutritional status in hemodialysis patients.Methods: The hemoglobin(HB),albumin(ALB),triglyceride(TG),high-density lipoprotein(HDL),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),and lipoprotein a(Lp(a)) in the hemodialysis patients were measured and compared with those of normal control.Results: Compared with the normal control,plasma TG,TC,ApoB,and Lp(a) in hemodialysis patients were significantly higher(P<0.05),while plasma HDL, ApoA1,ALB,and HB significantly Lewer(P<0.05).There were positive correlations between ALB and ApoA1,ALB and HDL,Lp(a) and TG,Lp(a) and TC,and Lp(a) and Apo B.There were negative correlations between ALB and TG,ALB and TC,ALB and ApoB,Lp(a) and HB,Lp(a) and ALB,and Lp(a) and ApoA1.Conclusions: The disturbances of lipid metabolism in plasma are evident in hemodialysis patients,which are correlated with long term of anaemia and malnutrition and might be factors causing coronary heart disease.