血液透析冠心病患者低密度脂蛋白/高密度脂蛋白与氧化应激的临床研究

目的:探讨血液透析冠心病患者血脂低密度脂蛋白(LDL)/高密度脂蛋白(HDL)与氧化应激的临床意义。方法:采用回顾性方法分析2010年1月—2013年12月住院的所有血液透析合并冠心病患者临床资料。对照组为无冠心病者33例,观察组为冠心病者20例,分别检测各组患者LDL,HDL、血清晚期蛋白氧化产物(AOPPs)、血清超氧化物歧化酶(SOD)及丙二醛(MDA)等变化。结果:两组的HDL及LDL/HDL比较,差异有统计学意义(P<0.05),两组的SOD,MDA及AOPPs比较,差异有统计学意义(P<0.05)。提示冠心病患者中LDL明显升高,而HDL明显降低,同时存在明显的氧化应激产物水平升高。采用逐步回归相关分析研究,经过逐步拟合,得出回归方程:y=6.884-4.811X2+1.249X3-0.057X4,结果表明LDL/HDL比值与LDL,HDL及SOD存在线性回归关系。由标准回归系数看出LDL/HDL比值与LDL关系最大。结论:在血液透析冠心病患者中,其血脂LDL/HDL比值变化可能与氧化应激之间存在一定的相关性。

The clinical study on LDL/HDL and oxidative stress of hemodialysis coronary heart disease

Objective：To discuss the clinical significance of low density lipoprotein（LDL）/ high - density lipoprotein （HDL）and the oxidative stress in the hemodialysis patients with coronary heart disease. Methods：Date of all hemodialysis patients with coronary heart disease in the hospital during the period of January 2010 to December 2013 were analyzed with a retrospective method. 33 hemodialysis patients without coronary heart disease as Control group,20 hemodialysis patients with coronary heart disease as observation group. LDL,HDL,erum protein oxidation product late（AOPPs）,serum superoxide disproportionation enzyme（SOD）and malondialdehyde（MDA）of patients were detected in etc. Results：There were statistically signifi-cant differences in ratio of HDL and LDL/ HDL between two groups（P ﹤ 0. 05）,there were statistically significant differences in SOD,MDA and AOPPs between two groups（P ﹤ 0. 05）. Hint：LDL in patients with coronary heart disease increased significantly,and HDL lower significantly,in the same time level of product of oxidative stress rised obviously. The regression equation was obtained：y = 6. 884 - 4. 811X2 ＋ 1. 249X3 - 0. 057X4,the results showed that a relationship exist among the ratio of LDL / HDL and LDL,HDLand SOD. The standard regression coefficient show that relationship between ratio of LDL / HDL and LDL was the largest. Conclusion：There may be a certain correlation between oxidative stress and change of LDL/ HDL ratio in hemodialysis patients with coronary heart disease.