血液透析患者脂蛋白代谢的探讨

目的 :探讨慢性肾功能衰竭血液透析患者脂蛋白变化的临床意义。方法 :TCH、TG、BUN、Cr采用酶化学法 ,HDL- C、L DL- C采用遮蔽一步酶法 ,Apo A1 、Apo B1 0 0 、L p(a)采用免疫散射比浊法。结果 :BUN在 HD前 (35 .71±9.76 ) m mol/ L 降为 (10 .0 6± 4 .77) mm ol/ L,CR由 HD前 (96 3.33± 2 86 .15 ) μmol/ L 降为 (42 7.5 3± 15 6 .81) μm ol/ L,两者有明显差异 (P<0 .0 1) ,其他项目 HD前后无明显变化 ,但 TG在 HD前 (1.86± 0 .75 ) mmol/ L,HD后 (2 .0 3± 0 .78) mmol/ L,L p(a)在 HD前 (36 4 .8± 12 3.6 7) mg/ L,HD后 (430 .7± 135 .0 ) mg/ L,虽透析前后无明显变化 (P>0 .0 5 ) ,但与正常人比较差异均有显著性 (P<0 .0 1)。结论 :TG、L p(a)等脂蛋白血清浓度可作为慢性肾功能衰竭 HD患者心脑血管并发症及血栓形成的预示指标。

An Investigation of Lipoprotein Metabolism in Hemodialyzed Patients

Objective To investigate the clinical value of lipoprotein's saltemation in chronic renal failure(CRF)patients treated by hemodialysis.Methods TCH?TG?BUN?Cr?HDL-C and LDL-C were assayed enzymatically,and APOA 1?APOB 100 ?Lp(a)were measured immunotur-bidimetrically in 28 CRF patients before and after hemodialysis.Results Before hemodialysis,BUN was (35.71±9.76)mmol/L,and decreased to (10.06±4.77)mmol/L after hemodialysis,which was significantly lower (P<0.01) than prehemodialysis,and Cr too(963.33±286.15)μmol/L~(427.53±156.81)μmol/L,There were no significant difference among other parameters.Nevertheless,comparing with controls,TG and Lp(a)were increased significantly in patients treated by hemodialysis(P<0.01);though prehemodialysis,TG was (1.86±0.75)mmol/L.Lp(a)was (364.8±123.67)mg/L,and posthemodialysis,TG was (2.03±0.78)mmol/L,Lp (a)was (430.7±135.0)mg/L,which had no significant difference(P>0.05).Conclusion Serum lipoproteins such as TG?Lp(a) may be regarded as predicting parameters of cerebrocardiac vascular complication in CRF patients.