血液透析对慢性肾功能衰竭患者血清脂质代谢的影响

目的 探讨经血液透析治疗慢性肾功能衰竭（简称慢性肾衰）患者血清脂质水平对心血管及肾脏的影响。方法 测定了98例慢性肾衰患者（53例为非透析组）血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、LDL／HDL、载脂蛋白（Apo)A1、ApoB以及ApoA1/ApoB的含量与40例正常人进行对照研究。结果 慢性肾衰患者脂质代谢异常，表现TG、LDL、LDL／HDL增高，HDL、ApoA1、ApoA1/ApoB降低。慢性肾衰血液透析组同样存在脂代谢异常，与慢性肾衰非透析组相比较，LDL及LDL／HDL增高有明显差异（P＜0．05），而TG、HDL、ApoA1、ApoB以及ApoA1/ApoB无显著变化。结论 ①慢性肾衰患者可引起继发性脂质代谢紊乱；②慢性肾衰患者行血液透析不能纠正其脂质代谢紊乱，反而使其紊乱加重。

Research on the serum lipoprotein in uremic patients

Objective To investigate the changes of the serum lipoprotein metabolism and the effects of hemodialysis on the disorders of serum lipoprotein metabolism.Methods We determined serum lipoproteins in 98 uremic patients compared with controls. Results The patients with uremia had significantly increased levels of TG,LDL,LDL/HDL and reduced the levels of HDL,ApoA 1,ApoA 1/ApoB. Compared with nonhemodialyzed patients, the levels of LDL and LDL/HDL in dialyzed patients were markedly higher ( P <0.05) and the levels of TG,HDL,ApoA 1,ApoA 1/ApoB in dialyzed patient were not significantly different ( P >0.05).Conclusion There is a disorder of the serum lipoprotein in uremic patients;Compared with nondialyzed patients with uremia, these uremic patients with maintenance hemodialysis (MHD) treatment have significant change in their levels of serum lipoprotein,which suggest that hemodialysis can't improve disorders of the serum lipoprotein metabolism, adversely aggravate its disorder.